Role of imaging in the management of lateral sinus thrombosis

Abstract

It usually occurs as a complication of attico antral type of chronic otitis media and here direct dissemination of the infection will occur through the adjacent eroded bone. Many authors have reported lateral sinus thrombosis in patients with intact bony sinus plate. This suggests thrombophlebitic spread through the small emissary vein.3‒7 Its incidence LST is decreased because of the availability of good broadspectrum antibiotics, availability of CT and MRI scans and micro surgical treatment. Now LST is a rare complication of otitis media. Otologist should be familiar with this clinical entity and it should be diagnosed early for good outcome.1,8 Radiological investigations play an important role in the diagnosis of LST. Definitive diagnosis of LST is made at surgery. CT and MRI are the investigations that are needed for correct diagnosis. In LST, CT scan with contrast shows a classic ‘delta sign’ of perisinus dural enhancement and filling defect of the lateral sinus (Figure 1). The ‘delta sign’ is not always detectable in CT.In patients with LST, along with MRI, CT scan also should be done to rule out other associated extra cranial and intracranial complications of otitis media.9‒14