Table 1 Summary of the reported cases of otogenic sinus thrombosis in children from 2011 to 2020

Bevan, 2020, United Kingdom

[8]

3–11 years

7 M

4 F

Not reported

Papilledema, Abducens nerve palsy, strabismus, visual defect, seizures

2 SS

2 TS

4 SS + TS + IJV

1 SS + IJV

1 SS + TS

1 IJV

1 epidural abscess

11 otitic hydrocephalus

7mastoidectomy

3 mastoidectomy and myringotomy

1 mastoidectomy, myringotomy, craniotomy

LMWH;

Rivoxaban

(not clarified)

Broad spectrum antibiotic

Not clarified

Not clarified

Coutinho, 2018, Portugal

[6]

2–16 years

7 M

9 F

Ear pain, headache, lethargy, nausea, vomiting, fever

neck stiffness

Abducens nerve palsy, papilledema

4 SS

2 TS

6 SS, TS

4 SS, TS, IJV

5 epidural abscess

3 otitic hydrocephalus

1 epidural abscess, meningitis

16 Mastoidectomy, transtimpanic ventilation tube

7 perioperative sigmoid sinus exposure

3 drainage perisinus empyema

5 craniotomy

UFH; LMWH; warfarin

(3–12 months)

Broad spectrum antibiotic

2 neuro-ophtalmological impairment

1 HDAD

1 non-specific behaviour disorder

3 partial recanalization

7 complete recanalization

Scorpecci, 2018, Italy

[9]

1–14 years

17 M

8 F

Ear pain,signs of mastoiditis, headache, othorrea, neck stiffness

VI cranial nerve

palsy, altered consciousness, papilledema, vertigo

16 SS

4 SS + TS

1 SS + cavernous sinus

1 SS + sagittal sinus

2 SS + jugular bulb

2 epidural abscess

1 cerebellar abscess

16 mastoidectomy and tympanostomy tube insertion

3 abscess evacuation through an occipital craniotomy approach

LMWH

(at least 2 months)

Broad spectrum antibiotic

1 persistent bilateral

optic nerve atrophy and subsequent impaired visual acuity

20 complete recanalization

2 partial recanalization

3 no complete follow-up

Scherer, 2017, USA

[10]

6 years

M

Headache, ear pain, blurry vision, nausea, vomiting

Papilledema,

Abducens nerve palsy

SS, TS, IJV

None

Mastoidectomy, myringotomy, tube placement

LMWH

(6 months)

Broad spectrum antibiotic

No sequelae

Complete recanalization

Ryan, 2016,

USA

[11]

6–15 years

4 M

3 F

Fever, ear pain, othorrea, neck stiffness

Papilledema

7 SS

7 TS

5 IJV

2 epidural abscess

2 otitic hydrocephalus

1 meningitis

1 cavernous sinus thrombosis

Mastoidectomy and tympanostomy tube

2 epidural abscess drainage

5 patients; not clarified

Broad spectrum antibiotic

1 right visual-field deficit

6 no sequelae

In 1 patient persistent thrombosis after 9 months.

Not clarified for the other patients

Zanoletti, 2015, Italy

[7]

2–7 years

4 M

4F

Fever, headache, ear pain

lethargy

6 papilledema

3 diplopia

2 photophobia

1 facial paralisis

8 SS

6 TS

4 IJV

1 epidural abscess

5 mastoidectomy

2 transtimpanic drainage

2 myringocentesis

UFH; LMWH

(3 months)

Broad spectrum antibiotic

No sequelae

5 complete recanalization

1 partial recanalization

1 sinus entirely distrupted

Rosdy, 2014, Hungary

[12]

4–8 years

6 M

4 F

Fever, headache, ear pain, otorrhea, lethargy, vomiting, neck stiffness,

torcicollis

9 papilledema

2 abducens nerve palsy

3 ataxia

10 SS

5 TS

3 IJV

4 perisinous abscess

1 epidural abscess

1 cerebellar abscess

10 mastoidectomy

2 thrombectomy

1 IJV ligation

1 epidural abscess drainage

8 patients LMWH

(3–6 months months)

Broad spectrum antibiotic

1 unilateral visual deficit

5 complete recanalization

2 partial recanalization

Funamura, 2014,

USA

[5]

1–15 years

4 M

1 F

Fever, ear pain, headache, nausea, vomiting, otorrhea, lethargy

1 patient presented seizures after intracranial hemorrage

5 SS

4 TS

2 IJV

2 epidural abscess

1 brain abscess

4 mastoidectomy

1 myringotomy with tympanostomy tube

1 IJV drainage

1 craniotomy with drainage of brain abscess

3 epidural abscess drainage

3 patients UFH (3 days-3 weeks) followed by LMWH (3–6 months)

Broad spectrum antibiotic

1 epilepsy and developmental delay

1 headache

2 partial recanalization

1 complete recanalization

Ulanovski, 2014, Israel

[13]

7 months-12 years

10 M

14 F

Fever, ear pain

1 abducens nerve palsy

3 seizures

9 SS

6 SS + TS

4 SS + IJV

4 SS + TS + IJV

1 cavernous sinus

11 epidural involvement

5 temporal bone osteomyelitis

21 mastoidectomy + decompression of the sinus

3 none intervention

22 patients LMWH (3–6 months)

Broad spectrum antibiotic

No sequelae

7 complete recanalization

6 partial recanalization

2 persistence obstructed vessels

Au, 2013, USA

[14]

14 years

M

Fever, ear pain, otorrhea, headache, vomiting, fatigue, visual allucinations, blurry vision

Not reported

TS + SS

Epidural abscess

Myringotomy, tube placement, mastoidectomy

Not performed

Broad spectrum antibiotic

No sequelae

Complete recanalization

Novoa, 2013, Switzerland

[15]

1–13 years

6 M

3 F

Fever, ear pain, otorrhea, headache, vomiting, apathy

2 abducens nerve palsy

1 vertigo

5 SS

3 SS+ IJV

1 SS + TS

4 otitis hydorcephalus

4 subperiostal abscess

2 epidural abscess

Mastoidectomy and tympanostomy tubes

6 patients LMWH (3–6 months)

3 patients UFH (2,7,21 days) followed by LMWH in 1 patient (3 months), acetylsalicylate in 1 patient (6 months), phenprocoumon in 1 patient (11 months)

Broad spectrum antibiotic

1 patient presented moderate hearing loss, persistence of increased intracranial pressure, headache, legasthenia and atrophy of optic nerve

7 complete recanalization

2 persistent recanalization

Csakanyi, 2013, Hungary

[16]

4–8 years

6 M

2 F

Fever, ear pain, headache, lethargy, nausea, vomiting, neck stiffness, torcicollis

1 ataxia

1 bradycardia

2 SS

1 SS + TS

4 SS + TS + IJV

1 only granulation

Not reported

6 mastoidectomy + decompression of sinus

1 mastoidectomy + thrombectomy

1 mastoidectomy + thrombectomy + IJV ligation

6 patients LMWH

(2–6 months)

Broad spectrum antibiotic

1 permanent visual loss

7 complete recanalization

In patient with IJV involvement a good collateral circulation was observed

Van Munster, 2013, The Netherlands

[17]

3 years

F

Fever, left side otorrhea, vomiting

abducens nerve palsy

Sinus thrombosis

(not specified)

Cerebellar empyema

Mastoidectomy + thrombectomy

LMWH

(not clarified)

Broad spectrum antibiotic

No sequelae

Complete recanalization

Inkuchi, 2013, Japan

[18]

5 years

M

Nausea, vomiting, headache

None

TS + SS + IJV

Not reported

Ventricle-peritoneal shunt + ventilation tube insertion

Not performed

Not reported

No sequelae

Complete recanalization

Sitton, 2012, United States

[19]

2–15 years

5 M

2 F

Fever, ear pain, otorrhea, vomiting, headache, neck stiffness, mastoid tenderness

Diplopia

SS (2)

SS + TS (3)

SS + IJV (2)

1 subperiostal abscess

3 mastoidectomy + myringotomy and tube placement

1

mastoidectomy + aspiration of sinus

1

myringotomy, tube placement and drainage of subperiostal abscess

2

myringotomy, tube placement

6 patients LMWH. Of these 3 patients previously received UFH and 4 switched to warfarin.

(1.5–6 months)

Broad spectrum antibiotic

No sequelae

6 complete recanalization

1 no resolution

Zangari, 2012, Italy

[20]

3–10 years

4 M

1 F

Fever, headache, asthenia, vomiting, signs of mastoiditis

Diplopia, photophobia

3 SS

2 SS + TS

None

2 mastoidectomy

3 none

LMWH for 3 months. In 1 patient LMWH was followed by oral anticoagulant for 6 months.

Broad spectrum antibiotic

No sequelae

3 complete recanalization

1 partial recanalization

1 no resolution

Ropposch, 2012, Austria

[21]

3–15 years

6 M

Headache, neck stiffness, fever, ear pain, post-auricular pain and erythema, otorrhea

1 Vertigo

1 Abducens nerve palsy

3 SS + TS

3 SS + IJV

None

3 mastoidectomy + thrombectomy

2

mastoidectomy

+ ligation IJV

UFH followed by LMWH

(3 months)

Broad spectrum antibiotic

1 hydrocephalus and papilledema that rgressed after 6 months

3 complete recanalization

Ghosh, 2011, USA

[22]

5 months-18 years

9 M

4 F

Headache, vomiting, fever, otorrhea

4 abducens nerve palsy

1 facial nerve palsy

5 papilledema

Ataxia

8 TS

5 TS + SS + IJV

None

4 mastoidectomy

5 mastoidectomy + myringotomy and ventilation tube

1 myringotomy with tube ventilation

3 LMWH

(6 months)

Broad spectrum antibiotic

4 transient hearing loss

1 permanent hearing loss

3 complete recanalization

2 partial recanalization

Bielecki, 2011, Poland

[23]

3–9 years

3 M

2 F

Headache, ear pain, fever, vomiting

6 papilledema

3 diplopia

3 facial nerve

palsy

1 SS

1 SS + TS

1 SS + IJV

1 SS + TS + IJV

1 SS + TS + IJV + SGS

None

5 mastoidectomy + ventilation tube placement

4 UFH, followed by LMWH and acenocoumarol

(6 months)

Broad spectrum antibiotic

No sequelae

5 partial or complete recanalization (not clarified)

Viswanatha, 2011, India

[24]

8–12 years

6 M

3 F

Headache, ear pain, fever, vomiting, vertigo

1 Facial nerve palsy and

lateral rectus palsy

TS

4 cerebellar abscess

3

meningitis, 1 temporal lobe

abscess

1 otitic hydrocephalus

9 mastoidectomy + thrombectomy

drainage of intracranial

abscesses

Not performed

Broad spectrum antibiotic

No sequelae

Not reported

Neilan, 2011, USA

[25]

6 months - 14 years

10 M

5 F

Not reported

5 diplopia

2 SS

3 SS + TS

1 SS + IJV

8 SS + TS + IJV

1 SS + CS + IJV

5 otitic hydrocephalus

15 mastoidectomy and tympanostomy tube placement

+

3 needle decompression

3 osseous decompression

6 venotomy

12 patients LMWH

(6 weeks-6 months)

Not reported

Not reported

4 persistence obstructed vessels

2 complete recanalization

8 partial recanalization