S状静脈洞血栓症を伴った乳様突起炎例

概要

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Mastoiditis is one of common suppurative complications of acute otitis media, which sometimes induces severe intracranial complications. We report on a case of mastoiditis accompanied with sigmoid sinus thrombosis. A 12-year-old girl presented with repeated otalgia and aural discharge in her right ear which had persisted for 2 months. Computed tomography (CT) examination revealed a defect of the lateral wall of the sigmoid sinus with stenosis. The patient underwent total mastoidectomy. She has been alive without neurological manifestations for 7 months, and the sigmoid sinus has been enlarged without anticoagulation therapy. The development of antibiotics has decreased the frequency of mastoiditis, although the mastoiditis without clinical symptoms has been reported in recent years. CT examination is a decisive diagnostic tool to classify the mastoiditis as incipient or coalescent, to detect intracranial complications, and to determine the type of therapy. Thrombophlebitis is one of the life threating intracranial complications of mastoiditis, but if it is localized in only one hemisphere and has no neurological manifestations, it can be followed without surgery.