Otogenic sigmoid sinus thrombosis in pediatric ENT-practice

Otogenic sigmoid sinus thrombosis is a rare complication of acute otitis media and mastoiditis in pediatric age group, but has a high risk of lethal outcome. In our data in the period 2019–2024 in the ENT-department of the 3rd Minsk City Children’s Clinical Hospital, operations anthrotomy (or anthromastoidotomy) was performed on 83 patients whis a complicated course of acute purulent otitis media. The most frequent complication of otitis media was anthromastoiditis. 5 patients (6 %) had intracranial complications: otogenic meningitis – 4 (4,8 %) and sigmoid sinus thrombosis – 1 (1,2 %). Symptoms of sinus thrombosis are usually divided into two groups: local (circulatory) and general (infectious) and in typical cases the diagnosis is not doubtful but the use of antibiotics can change the symptoms and course of inflammation in the middle ear and sigmoid sinus which complicates diagnosis. Diagnostically significant information is provided by MRI and CT of the skull with contrast. Diagnosis of sigmoid sinus thrombosis in most cases requires urgent surgical intervention in the middle ear with exposure of the sigmoid sinus wall. Postoperative treatment includes the administration of antibiotics, anticoagulants, thrombolytics, non-steroidal anti-inflammatory drugs and detoxification therapy.