An Update on the Management of Otogenic Cerebral Sinus Thrombosis: A Systematic Review

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2026-06-03 Epub Date: 2026-04-10 DOI:10.1111/coa.70107

Charles Picton, Joseph Rassam, Claire Lloyd-Davies, Mihir Gajre, Iain Mckay-Davies

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引用次数: 0

Abstract

Introduction

Otogenic cerebral sinus thrombosis (OCST) represents a rare but serious pathology. The medical and surgical treatment to achieve optimal patient outcomes remains unclear. This review assesses the published evidence of OCST to guide best practice.

Methods

A search of electronic databases Medline, Embase, Emacare, Cochrane and Clinicaltrials.gov was conducted from inception to November 2024. Eligible studies were identified and relevant findings extracted.

Results

Sixty-eight papers, 43 case reports and 25 case series met the inclusion criteria with a total of 149 patients. 88.5% of patients underwent surgery, most commonly cortical mastoidectomy. 54.8% of patients received anticoagulation. Sixty-five percent of patients with reimaging had complete recannalisation of the sinus and 9.4% of patients experienced long term complications.

Conclusions

The combination of antibiotics, anticoagulation and surgery was associated with the most favourable outcome. Mastoidectomy and decompression of the sigmoid were commonly performed and largely safe. However, no additional benefit of incision and drainage of the sigmoid sinus was found and this was associated with a higher complication rate.

查看原文本刊更多论文

耳源性脑窦血栓形成治疗的最新进展：系统回顾。

耳源性脑窦血栓形成（OCST）是一种罕见但严重的病理。目前尚不清楚如何通过药物和手术治疗来达到最佳的治疗效果。本综述评估了已发表的OCST证据，以指导最佳实践。方法：检索Medline、Embase、Emacare、Cochrane和Clinicaltrials.gov等电子数据库，检索时间自成立至2024年11月。确定了符合条件的研究并提取了相关结果。结果：符合纳入标准的论文68篇、病例报告43篇、病例系列25例，共纳入患者149例。88.5%的患者接受手术，最常见的是皮质乳突切除术。54.8%的患者接受抗凝治疗。65%的重新成像患者鼻窦完全再通，9.4%的患者出现长期并发症。结论：抗生素、抗凝和手术联合治疗是最有利的预后。乳突切除术和乙状结肠减压术是常用的手术方法，而且基本上是安全的。然而，没有发现乙状窦切开引流的额外好处，这与较高的并发症发生率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.