Ooi Eng Hooi, Hilton Malcolm, Hunter Garrett
Department of Otolaryngology, Royal Darwin Hospital, Northern Territory, Australia.
J Laryngol Otol. 2003 Dec;117(12):932-9. doi: 10.1258/002221503322683795.
The management of four cases of lateral sinus thrombosis (LST) over a four-year period at the Royal Darwin Hospital is presented in this retrospective review. The patients were aboriginal and presented with otalgia, otorrhoea and sepsis. Two cases had an associated complication of an otitic hydrocephalus and a subperiosteal abscess. Cholesteatoma was found in three cases. Computed tomography (CT) scan confirmed the LST in three cases. Three patients were anaemic and thrombocytopenic. All patients had positive blood cultures. The organisms were predominantly mixed anaerobes and Bacteroides species. Three patients were managed surgically as a two-stage procedure. One patient was managed as a single-stage procedure with a modified radical mastoidectomy. Therapeutic anticoagulation was utilized in one case. There were no deaths. The prognosis of LST is good if treatment is instituted early with broad-spectrum intravenous antibiotics and surgery. The role of clot removal at surgery and the use of anticoagulation are discussed in this paper.
本文通过回顾性研究，介绍了皇家达尔文医院在四年期间对4例外侧窦血栓形成（LST）的治疗情况。患者均为原住民，表现为耳痛、耳漏和败血症。2例伴有耳源性脑积水和骨膜下脓肿并发症。3例发现胆脂瘤。计算机断层扫描（CT）在3例中确诊为LST。3例患者贫血且血小板减少。所有患者血培养均为阳性。主要病原体为混合厌氧菌和拟杆菌属。3例患者接受了两阶段手术治疗。1例患者采用改良乳突根治术进行单阶段手术治疗。1例患者采用了治疗性抗凝治疗。无死亡病例。如果早期使用广谱静脉抗生素并进行手术治疗，LST的预后良好。本文讨论了手术中清除血栓的作用以及抗凝治疗的使用。
