Lateral Sinus Thrombosis in a Children

Objective: Describe the clinical and therapeutic aspects of septic lateral sinus thrombosis through a case in children. Clinical case: O.C 15 years old, male, shepherd, with history of CME of around 5 years, received urgently for headache, dizziness, vomiting and a notion of fever with purulent and fetid otorrhea on the left associated with otalgia and hypoacusis. Our physical examination found a fever of 39.5°C; neck tightness with pain along the left sternocleidomastoid muscle. Otoscopic examination revealed purulent and fetid otorrhea on the left with a scaly deposit. After aspiration we visualized a subtotal and marginal tympanic perforation with a moist base. The right ear is unremarkable. CT scan showed the Delta sign [Figure 1] as well as associated thromboses of the internal jugular vein [Figure 3] and the transverse sinus [Figure 2]. The treatment consisted of a left masto-atticotomy [Figure 4] with skeletonization of the lateral sinus as well as filling with abdominal fat, a cartilaginous tympanoplasty and 2 months of antibiotic therapy. We did not use anticoagulants. The evolution was marked by the regression of local and general signs without complications or after-effects. Conclusion: lateral sinus thrombosis is a serious complication of otitis media, especially in children, but rare. Its diagnosis is often delayed, hence the importance of emergency imaging in the face of suggestive signs. Early treatment is a prognostic guarantee to reduce morbidity and mortality.