S状静脈洞血栓症を来した乳突蜂巣炎症例

抄録

Otogenic intracranial complications, such as venous thrombosis, may occur successively in acute mastoiditis even in today’s era of antibiotics. We herein present a case of sigmoid sinus thrombosis secondary to mastoiditis. A 9-year-old boy was admitted to our hospital with persistent headaches after treatment for right acute otitis media at another hospital. The patient had no underlying disease, and there had been no recurrence of the otitis media so far. Magnetic resonance imaging (MRI) examination revealed hyperintensity in the right mastoid air cells, and magnetic resonance venography (MRV) examination showed a defect of the right sigmoid sinus. The patient was treated with anticoagulation therapy and insertion of a ventilation tube into the right ear. The patient survived without any permanent damage, and the sigmoid sinus has enlarged without undergoing mastoidectomy. Regarding otogenic intracranial complications including venous thrombosis, the frequency of onset has decreased due to the development of antibiotics. In some cases, however, detection of the disease is delayed because of the milder symptoms due to antibiotic use in recent years. It is necessary for otolaryngologists to consider intracranial complications particularly in cases with persistent headache after otitis media infection. Since the present patient was a child and frequent imaging was required, MRI/MRV examination without contrast dye and radiation exposure was effectively utilized in the follow-up of the disease.