Otogenic lateral sinus thrombosis in children

Introduction: The clinical picture of lateral sinus thrombosis (LST) has ch anged with the advent of antibiotics, as have the utility of various diagno stic tests. LST may appear in children as a complication of acute otitis me dia, but nowadays it is more frequently encountered in adults with long-sta nding chronic ear disease. Method: A retrospective study of all the pediatr ic patients with LST between 1982 and 1997. Results: Thirteen cases of LST were diagnosed and treated by our department. In six cases, LST was due to acute otitis media and in the remaining cases it was due to chronic otitis media. Headache, fever, aural discharge and mastoid tenderness were the mos t frequent findings in these patients and four patients were initially diag nosed with meningitis. In the majority of the patients, LST was accompanied with other intracranial complications, such as perisinus abscess, brain ab scess and meningitis. One patient with multiple blain abscesses, unresponsi ve to several drainage procedures, died. The other patients recovered and h ave since been followed-up as out-patients. Conclusion: LST may be difficul t to diagnose due to previous antibiotic treatment and to the overlap of cl inical findings with other entities such as meningitis. Despite the value o f modern imaging techniques in the investigation of the disease, a high ind ex of suspicion based on the clinical picture is warranted. Our results are consistent with those of other recent studies, who found that mortality of LST has dropped below 10%. (C) 1999 Elsevier Science Ireland Ltd. All righ ts reserved.