Lateral sinus thrombosis (LST) is a rare but potentially devastating complication of otitis media. We review the clinical presentation, evaluation, management, operative findings, and outcomes of this serious complication. A retrospective... more
Lateral sinus thrombosis (LST) is a rare but potentially devastating complication of otitis media. We review the clinical presentation, evaluation, management, operative findings, and outcomes of this serious complication. A retrospective chart review was performed at a teaching hospital of all patients diagnosed with an otogenic lateral sinus thrombosis between 1992 and 2002. Data on patients with otogenic LST were collected and analyzed. Eleven patients were identified with a diagnosis of lateral sinus thrombosis, and all had a chronic otitis media. The most common presenting symptoms were headache, otalgia, and fever. Radiologic evaluation included computed tomography scan, magnetic resonance imaging, or magnetic resonance venography. All patients had radiographic evidence of LST preoperatively. The thrombosed sinus was on the right side in 6 patients and on the left side in 5 patients. The majority of patients (8 of 11) had a second concomitant intracranial complication. All patients underwent a mastoidectomy. The thrombus was removal in 7 cases, whereas only needle aspiration of the sinus was performed in 4 cases. Gram-negative bacilli and anaerobes were the most common organisms. There were no deaths but sequelae included VI nerve palsy, ataxia, and dead ear. LST as a complication of otogenic infections may still pose a serious threat that warrants immediate attention and care. It is frequently associated with other intracranial complications. Contrast-enhanced computed tomography scan and magnetic resonance imaging plays a major role in determining diagnosis and treatment plans. The availability of broad-spectrum antibiotics has improved our management significantly. Conservative surgical intervention including eradication of all perisinus infection and needle aspiration of the sinus seems to be effective.
This case report describes a case of carotid space abscess secondary to lateral sinus thrombosis associated with internal jugular vein thrombosis. With this case, we illustrate a rare entity that presented in an extremely rare manner. To... more
This case report describes a case of carotid space abscess secondary to lateral sinus thrombosis associated with internal jugular vein thrombosis. With this case, we illustrate a rare entity that presented in an extremely rare manner. To the authors knowledge such a case has not been previously reported.
Keratosis obturans is a rare entity which presents with pain, conductive hearing loss and very rarely facial nerve palsy due to pressure effects. HRCT temporal bone can help in differentiating keratosis obturans from canal cholesteatoma... more
Keratosis obturans is a rare entity which presents with pain, conductive hearing loss and very rarely facial nerve palsy due to pressure effects. HRCT temporal bone can help in differentiating keratosis obturans from canal cholesteatoma and can also show any pressure effects on facial canal. Prompt diagnosis and its differentiation from other similar conditions like canal cholesteatoma and impacted wax is warranted to avoid complications.
Background: Rhinoliths are mineralized foreign bodies in the nasal cavity and are diagnosed based on the presenting illness and clinical examination. Giant nasal stones are very rare in occurrence, since improved diagnostic techniques now... more
Background: Rhinoliths are mineralized foreign bodies in the nasal cavity and are diagnosed based on the presenting illness and clinical examination. Giant nasal stones are very rare in occurrence, since improved diagnostic techniques now make it possible to identify foreign bodies at an early stage of disease. The aim of the study was to revisit this rare and forgotten clinical entity with the variations in presentation in the hilly population of uttarakhand and treatment revisited.Methods: We report a case series of 33 patients with rhinoliths who presented to our institute over a period of 10 years, from January 2007 to January 2017. Results: Average age was 25.48 years (range: 5 years to 60 years). 19 were female and 14 male. The incident was reported by a family member/attendant in 12.1% of cases (4 cases), discovered following nasal symptoms in 84.84% (28 cases) and was incidentally discovered in 3.03% (1 case). Symptoms comprised rhinorrhea associated with unpleasant nasal o...
Background: Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal cavity and paranasal sinuses. Azithromycin, a macrolide antibiotic, a well-established class of anti-bacterial agents, which also have anti-inflammatory... more
Background: Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal cavity and paranasal sinuses. Azithromycin, a macrolide antibiotic, a well-established class of anti-bacterial agents, which also have anti-inflammatory properties. The present study was designed to compare the role of azithromycin with surgical management in patients with chronic-rhinosinusitis.Methods: The study population included 60 adult patients with symptomatic CRS refractory to 3 weeks of medical therapy. The patients were divided in two groups with 30 patients in each group. One group of patients received oral Azithromycin as main treatment for 12 weeks while the other group of patients underwent sinonasal surgery. Symptom scoring and endoscopic scoring were done previous to the treatment and at 1 month and 3-month follow-ups.Results: A good subjective as well as objective outcome in terms of symptom improvement was obtained with in patients with chronic rhinosinusitis with Surgical interventio...
