Paediatric Otogenic Cerebral Venous Thrombosis: Diagnostic Approach and Therapeutic Management - A Five-Year Single-Centre Experience.

Abstract

<b>Introduction:</b> Central venous thrombosis (CVT) represents a well-documented complication of acute otitis media (AOM) and acute mastoiditis (AM). Despite widespread antibiotic utilization, which has significantly reduced the incidence of severe AOM/AM complications, recent years have witnessed an increasing frequency of thrombotic complications in pediatric patients, not invariably presenting with classical neurological manifestations.<b>Aim:</b> This study aimed to investigate the potential correlation between COVID-19 infection and increased CVT incidence, while sharing therapeutic experiences, given the absence of standardized treatment protocols for otogenic CVT in pediatric populations.<b>Materials and methods:</b>A retrospective observational analysis was conducted on patients admitted to the Department of Pediatric Otolaryngology at the Medical University of Warsaw for otogenic CVT between 2018 and 2023, with treatment completion by January 2024. The investigation encompassed the extent of thrombotic changes, concurrent complications, anticoagulation therapy modalities and duration, and therapeutic monitoring protocols.<b>Results:</b> The study cohort comprised 13 patients, with complete follow-up data available for 11 subjects. Low-molecular-weight heparin (LMWH) monotherapy achieved a 60% success rate (defined as complete recanalization), while combination anticoagulation therapy demonstrated a 16.67% success rate. Notably, all cases exhibited regression of active thrombosis, constituting a satisfactory therapeutic outcome.<b>Conclusions:</b> Anticoagulation therapy demonstrated both efficacy and safety, with no significant hemorrhagic complications observed. These findings underscore the necessity for multicenter analysis to establish evidence-based clinical guidelines.