Department of Otolaryngology, Royal Bristol Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
J Laryngol Otol. 2022 Jan;136(1):3-7. doi: 10.1017/S0022215121003145. Epub 2021 Oct 26.
Paediatric otogenic cerebral venous sinus thrombosis is a rare, heterogeneous and life-threatening condition, with possible otological, neurological and ophthalmological sequelae. Its course and outcomes can be widely variable. The publications available often consider individual aspects of paediatric otogenic cerebral venous sinus thrombosis management. The condition itself and the nature of the currently available guidance can lead to uncertainties when holistically managing patients with paediatric otogenic cerebral venous sinus thrombosis.
Clear recommendations for the comprehensive assessment and management of paediatric otogenic cerebral venous sinus thrombosis are presented, along with the literature review upon which they are based. Its clinical and radiological assessment are discussed.
A multidisciplinary approach to assessment and management is recommended, inclusive of infectious diseases, ENT surgery, neurology, ophthalmology and haematology. On balance, anticoagulation is recommended for three months. Follow-up imaging is not recommended in the absence of clinical concern. Follow up by ENT surgery, neurology and ophthalmology departments is recommended.
小儿耳源性脑静脉窦血栓形成是一种罕见的、异质性的、危及生命的疾病,可能伴有耳科、神经科和眼科后遗症。其病程和结局可能差异很大。现有的文献往往只考虑小儿耳源性脑静脉窦血栓形成管理的个别方面。该病本身以及现有指南的性质,使得在综合管理小儿耳源性脑静脉窦血栓形成患者时存在不确定性。
提出了小儿耳源性脑静脉窦血栓形成全面评估和管理的明确建议,并对其依据的文献进行了综述。讨论了其临床和影像学评估。
建议采用多学科方法进行评估和管理,包括传染病、耳鼻喉科手术、神经科、眼科和血液科。综合考虑,建议抗凝治疗三个月。在无临床指征的情况下,不建议进行随访影像学检查。建议耳鼻喉科手术、神经科和眼科等科室进行随访。