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Septic cavernous and lateral sinus thrombosis

Published online by Cambridge University Press:  29 June 2007

K. TveteråS
Affiliation:
Department of OtolaryngologySt. Joseph's HospitalDK-6700 Esbjerg, Denmark.
S. Kristensen
Affiliation:
Department of OtolaryngologySt. Joseph's HospitalDK-6700 Esbjerg, Denmark.
H. Dommerby
Affiliation:
Department of OtolaryngologySt. Joseph's HospitalDK-6700 Esbjerg, Denmark.

Abstract

The incidence of both lateral and cavernous sinus thrombophlebitis has been significantly reduced in the antibiotic era. Since septic cavernous sinus thrombosis (CST) is mainly a complication of facial abscesses and septic lateral sinus thrombosis (LST) is almost invariably due to chronic otitis media, both conditions are of clinical relevance to the otolaryngologist.

The predominant bacterium in septic CST is Staphylococcus aureus whereas in septic LST the bacteriology is very similar to that found in chronic otitis media. The diagnosis of septic CST can be established in most cases after thorough clinical examination, and contrast computerized tomography (CT) using the coronal projection usually confirms the clinical diagnosis. The signs and clinical course of septic LST are non-specific and the final diagnosis rests upon radiological investigations including CT-scan. The treatment of both conditions consists of broad-spectrum antibiotics, including beta-lactamase resistant penicillin in cases of septic CST. Most cases of septic LST also require surgical intervention.

Two cases oi septic intracranial sinus tiuombosis ate presented. The need for early diagnosis and treatment of this potentially lethal condition is emphasized.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1988

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