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儿童鼻源性海绵窦血栓形成

Cavernous sinus thrombosis of nasal origin in children.

作者信息

Varshney Saurabh, Malhotra Manu, Gupta Pratima, Gairola Priyanka, Kaur Navjot

机构信息

Department of E.N.T. & Head Neck Surgery/Microbiology, All India Institute of Medical Sciences, Rishikesh, 249201 Uttarakhand India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(1):100-5. doi: 10.1007/s12070-014-0805-4. Epub 2014 Nov 27.

Abstract

Cavernous sinus thrombosis is a rare presentation. Early diagnosis and aggressive treatment are required to prevent morbidity and mortality. Nasal infections can give rise to serious intracranial complications. Presented here is a case series of cavernous sinus thrombosis of nasal septic origin. The purpose of this article is to report our experience in pediatric patients with this illness to ascertain a clinical course and outcomes for further clinical application. Eight (08) cases of nasalseptic origin of cavernous sinus thrombosis ata tertiary care teaching hospital in the north India region of India were included in the study. Cases presented with various symptoms like headache, proptosis, ophthalmoplegia and fever. The patients were investigated by doing High Resolution Computed Tomography of nose & PNS and brain with intravenous contrast. The cases were treated with intravenous broad spectrum antibiotics. Eight patients less than 16 years of age (mean age of 11.2 years)diagnosed with cavernous sinus thrombophlebitis due to nasal septic focus over the period of 05 years were reviewed retrospectively. The predisposing infections and causative microorganisms were similar to previous reports in children. A conservative management strategy with antibiotics gave a good prognosis in these cases. There were no deaths. Early recognition of this condition, the appropriate selection of empirical antibiotic therapy, and the awareness of associated complication were the key factors leading to excellent outcome.

摘要

海绵窦血栓形成是一种罕见的病症。需要早期诊断和积极治疗以预防发病和死亡。鼻腔感染可引发严重的颅内并发症。本文介绍了一系列源于鼻腔感染的海绵窦血栓形成病例。本文的目的是报告我们在患有这种疾病的儿科患者中的经验,以确定临床病程和结果,供进一步临床应用。印度北部地区一家三级护理教学医院纳入了8例源于鼻腔感染的海绵窦血栓形成病例。病例表现出各种症状,如头痛、眼球突出、眼肌麻痹和发热。通过对鼻子、鼻窦和脑部进行静脉注射造影剂的高分辨率计算机断层扫描对患者进行检查。病例采用静脉注射广谱抗生素治疗。回顾性分析了5年间8例16岁以下(平均年龄11.2岁)因鼻腔感染灶诊断为海绵窦血栓性静脉炎的患者。诱发感染和致病微生物与先前儿童报告相似。在这些病例中,采用抗生素的保守治疗策略预后良好。无死亡病例。早期识别这种情况、正确选择经验性抗生素治疗以及认识相关并发症是取得良好结果的关键因素。

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