Tveterås K, Kristensen S, Dommerby H
Department of Otolaryngology, St. Joseph's Hospital, Esbjerg, Denmark.
J Laryngol Otol. 1988 Oct;102(10):877-82. doi: 10.1017/s0022215100106711.
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 of septic intracranial sinus thrombosis are presented. The need for early diagnosis and treatment of this potentially lethal condition is emphasized.
在抗生素时代，外侧窦和海绵窦血栓性静脉炎的发病率已显著降低。由于化脓性海绵窦血栓形成（CST）主要是面部脓肿的并发症，而化脓性外侧窦血栓形成（LST）几乎总是由慢性中耳炎引起，这两种情况对耳鼻喉科医生都具有临床相关性。化脓性CST中的主要细菌是金黄色葡萄球菌，而化脓性LST中的细菌学与慢性中耳炎中发现的非常相似。大多数情况下，经过全面的临床检查后即可确诊化脓性CST，使用冠状位投影的对比计算机断层扫描（CT）通常能证实临床诊断。化脓性LST的体征和临床过程不具有特异性，最终诊断依赖于包括CT扫描在内的影像学检查。这两种情况的治疗都包括使用广谱抗生素，化脓性CST病例需使用对β-内酰胺酶有抗性的青霉素。大多数化脓性LST病例也需要手术干预。本文介绍了两例化脓性颅内窦血栓形成的病例。强调了对这种潜在致命疾病进行早期诊断和治疗的必要性。
