Lateral sinus thrombosis in otology: a review

Abstract

Lateral sinus thrombosis (LST) is usually occurs as a complication of middle ear infection. The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days. The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.Anticoagulants are recommended in cases LST, where there is propagation of thrombus after surgery. The use of anticoagulants is not apart of standard care of patients with LST and was more common prior to the advent of antibiotics. Anticoagulants arrests the spread of thrombosis but may increase the risk of venous infarctions and should be used cautiously.

Figure 1:

MRI scan showing (arrow) occlusion and dilatation of left transverse and lateral sinus (with permission from Indian journal of Otolaryngology & head and neck surgery).

Figure 2:

MRI scan showing (arrow) post contrast enhancement of the sinus wall on the left side (with permission from Indian journal of Otolaryngology & head and neck surgery).