Lateral sinus thrombophlebitis
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Lateral sinus thrombophlebitis is an inflammation of the inner wall of the lateral venous sinus caused by infection from acute or chronic ear diseases. Bacteria enter the sinus and cause a thrombus formation within the sinus, obstructing drainage. Common symptoms include fever, headache, and papilledema. Diagnosis involves blood tests and imaging like CT or MRI. Treatment requires antibiotics, surgery to drain abscesses and remove clots, and sometimes anticoagulants or jugular vein ligation. Complications can include sepsis, meningitis, abscesses if not treated promptly.
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3.
Intracranial complications of CSOM
mastoidectomy
Follow up: long term antibiotics
Prognosis: depends on size,location,duration before treatment
Mortality: 10-20%
Morbidity: neurological deficits
Recurrence: 5-10%
Prevention: early treatment of ear infection
Education: personal hygiene
Socioeconomic: improved living standards
Intracranial complication of chronic suppurative otitis media
The document discusses several potential intracranial complications that can arise from chronic suppurative otitis media (CSOM), including:
1. Extradural abscess - pus collects between the bone and dura, often caused by bone erosion or thrombophlebitis.
2. Subdural abscess - pus collects against the brain surface, causing symptoms and becoming loculated.
3. Meningitis - inflammation of the meninges and bacterial invasion of CSF, presenting with fever, headache, neck stiffness.
4. Otogenic brain abscess - develops in the temporal lobe or cerebellum, presenting with headaches, seizures, and focal neurological deficits depending on
Complications of suppurative otitis media
This document discusses complications that can arise from suppurative otitis media, including mastoiditis, petrositis, facial paralysis, and others. It outlines factors that influence the development of complications such as age, socioeconomic status, and immune status. It also describes various pathways of infection spread and classifications of intracranial complications. Specific complications are then discussed in more detail including their causes, symptoms, treatments and more.
Complications of suppurative otitis media
1. Complications of suppurative otitis media can occur when infection spreads from the middle ear through direct bone erosion, venous thrombophlebitis, or preformed pathways.
2. Intratemporal complications include mastoiditis, petrositis, facial paralysis, and labyrinthitis. Acute mastoiditis occurs when infection spreads from the middle ear mucosa to the mastoid air cells.
3. Labyrinthitis can be circumscribed, diffuse and serous, or diffuse and suppurative with permanent hearing and vestibular loss if not treated promptly.
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The document discusses various classes of central nervous system stimulants including their mechanisms of action, effects, uses, and examples. It covers analeptic, respiratory, convulsant, psychomotor and sympathomimetic stimulants as well as methylxanthines such as caffeine and theophylline. Examples discussed include amphetamines, cocaine, nicotine and other stimulants.
Tracheostomy
The document discusses tracheostomy, which is a surgical procedure that creates an artificial opening in the trachea. It can be used to treat upper airway obstruction, assist with pulmonary ventilation, or help clear secretions from the lungs. The document outlines the anatomy of the trachea and various indications for tracheostomy. It also describes different techniques for performing a tracheostomy, as well as potential complications. Home care considerations are discussed.
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Intracranial complication of chronic suppurative otitis media
Intracranial complication of chronic suppurative otitis media
Similar to Lateral sinus thrombophlebitis
Complications of som
This document discusses intracranial complications that can arise from otitis media, including various types of abscesses, meningitis, sinus thrombosis, and hydrocephalus. Key complications mentioned are mastoiditis, labyrinthitis, extradural and subdural abscesses, otogenic brain abscess, lateral sinus thrombosis, and otitic hydrocephalus. Causes, clinical features, investigations, bacteriology, treatment, and pathology are described for several of these complications.
Complications of mastoiditis
Mastoiditis is an infection of the mastoid air cells that can develop as a complication of acute otitis media. It can present as acute or chronic and have various classifications. While now rare due to antibiotics, potential complications include intratemporal extensions into nearby structures or intracranial extensions through direct bone erosion. Management involves antibiotics, with mastoidectomy sometimes needed for severe or unimproving cases to prevent serious complications. Complications range from local abscesses to epidural abscesses, venous sinus thrombosis, and even more serious intracranial infections if not properly treated.
CHRONIC RHINOSINUSITIS complications ENT-HNS.pptx
This document discusses complications that can arise from rhinosinusitis. It begins by describing how infections can spread locally from the paranasal sinuses to nearby areas like the orbit or skull. It then categorizes complications and discusses specific types like orbital cellulitis and subperiosteal abscesses. The document also covers intracranial complications such as brain abscesses, subdural empyemas, and cavernous sinus thrombosis that develop from sinus infections spreading through anatomical pathways. Throughout, it provides details on presentations, risk factors, and management considerations for various rhinosinusitis complications.
COM complications
This document discusses various complications that can arise from chronic suppurative otitis media (CSOM). It classifies complications as either intracranial or extracranial/intratemporal. Some potential complications described include mastoiditis, facial nerve paralysis, labyrinthitis, petrositis, subperiosteal abscesses, meningitis, brain abscesses, otitic hydrocephalus, extradural abscesses, subdural abscesses, and lateral sinus thrombosis. Factors that influence the risk of these complications include pathogen virulence, patient immune status, and anatomical defects.
Complications of csom Dr.sithanandha Kumar,29.02.2016
Complications of chronic suppurative otitis media (CSOM) can include both intracranial and extracranial complications. Intracranial complications include meningitis, lateral sinus thrombosis, brain abscess, otitic hydrocephalus, and extradural/subdural abscesses. Extracranial complications involve spread of infection to nearby structures like the mastoid bone, petrous bone, facial nerve, and labyrinth. Prompt diagnosis and treatment of complications is important to prevent morbidity.
Complications of csom dr.sithanandha kumar,29.02.2016
Complications of chronic suppurative otitis media (CSOM) can include both intracranial and extracranial complications. Intracranial complications include meningitis, lateral sinus thrombosis, brain abscess, otitic hydrocephalus, and extradural/subdural abscesses. Extracranial complications involve spread of infection to nearby structures like the mastoid bone, petrous bone, facial nerve, and labyrinth. Prompt diagnosis and treatment of complications is important to prevent morbidity.
Complications of Chronic Otitis Media
This document discusses various complications that can arise from chronic suppurative otitis media (CSOM). It describes intra-cranial and extra-cranial complications, including mastoiditis, facial nerve paralysis, labyrinthitis, petrositis, subperiosteal abscesses, meningitis, brain abscesses, otitic hydrocephalus, extradural abscesses, subdural abscesses, and lateral sinus thrombosis. For each complication, it discusses the pathology, clinical features, investigations, and treatment approaches.
Complication of CSOM
all extra cranial & intracranial complication,etiology,pathology,investigation ,treatment according to reference book of Otolaryngology.
Complications of csom dr.sithanandha kumar 29.02.2016
The document discusses various complications that can arise from otitis media, including both intracranial and extracranial complications. It defines complications as the spread of infection beyond the middle ear cleft. Some of the major complications discussed include mastoiditis, meningitis, lateral sinus thrombosis, brain abscess, and facial nerve paralysis. The document provides details on the symptoms, diagnostic approach, and treatment for several of these serious complications of otitis media.
Lateral sinus thrombloplebitis and otitic hydrocephalus
Lateral sinus thrombophlebitis is an inflammation of the inner wall of the lateral venous sinus with thrombus formation, which can occur as a complication of acute or chronic middle ear infections. Key features include formation of a perisinus abscess, endophlebitis and mural thrombus, obstruction of the sinus lumen and potential spread of the thrombus. Otitic hydrocephalus is characterized by increased intracranial pressure despite normal cerebrospinal fluid, and can result when lateral sinus thrombosis extends to obstruct the superior sagittal sinus, impeding cerebrospinal fluid absorption. Treatment involves antibiotics, mastoid surgery, reducing intracranial pressure medically or with shunting
INTRACRANIAL COMPLICATIONS OF CSOM
This document discusses various intracranial complications that can arise from chronic otitis media, including:
1. Meningitis, which is the most common complication and occurs when infection spreads from the middle ear to the membranes covering the brain.
2. Extradural and subdural abscesses, which develop when infection spreads through the bone and collects between the skull and brain or between the brain's membranes.
3. Brain abscesses, which usually form when infection extends from the middle ear into the brain tissue, commonly through areas of bone dehiscence. Lateral sinus thrombophlebitis involves infection and clot formation within the venous sinus near the ear.
8. deep neck space infections
Ludwig's angina is a rapidly progressing cellulitis of the submandibular space that can cause airway compromise. It is usually caused by dental or periodontal infections and treated with IV antibiotics and incision and drainage. Parapharyngeal abscesses are usually caused by infections from the pharynx, teeth, or ears and can spread to nearby structures. Acute retropharyngeal abscesses commonly affect young children and are treated with IV antibiotics and drainage, while chronic abscesses are often tuberculous and require long term antibiotics. All three infections require prompt treatment to prevent complications including airway obstruction.
orbital cellulitis
1. Orbital cellulitis is an acute infection of the soft tissues behind the orbital septum that may progress to a subperiosteal or orbital abscess.
2. It is commonly caused by bacteria like Streptococcus pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes entering through the sinuses, face, or eyes.
3. Symptoms include eye swelling, pain, and vision issues. Left untreated, it can lead to complications affecting the eye, orbit, sinuses, or brain.
EXTRACRANIAL /INTRATEMPORAL COMPLICATIONS OF CSOM
1) Facial nerve palsy is a potential complication of both acute and chronic suppurative otitis media (CSOM). The facial nerve can become inflamed or damaged, causing weakness or paralysis of the muscles on the affected side of the face.
2) Labyrinthitis refers to inflammation of the inner ear structures and can occur when infection spreads from CSOM to the inner ear through defects in the otic capsule bone. This can cause symptoms like vertigo, hearing loss, and nystagmus.
3) Acute mastoiditis is inflammation of the air cells in the mastoid bone behind the ear. It develops when infection from the middle ear spreads to the mast
Complication of chronic rhinosinusitis
This document outlines various potential complications of chronic rhinosinusitis that can affect the orbit, intracranial cavity, and bones. It describes orbital complications such as preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, and cavernous sinus thrombosis. Intracranial complications discussed include meningitis, epidural abscess, subdural abscess, intracerebral abscess, cavernous sinus thrombosis, and sagittal sinus thrombosis. Bone complications include osteomyelitis (Pott's puffy tumor). Chronic complications include mucocoeles.
13 csom-part-4
This document discusses complications that can arise from suppurative otitis media, or middle ear infection. It defines these complications and categorizes them as either intra-cranial, intra-temporal, or extra-cranial/extra-temporal. Specific complications covered include mastoiditis, facial nerve palsy, labyrinthitis, lateral sinus thrombophlebitis, meningitis, and brain abscess. Treatment options are provided for various complications and include antibiotics, surgery such as mastoidectomy, and drainage of abscesses. Factors affecting the development of these complications and routes of infection spread are also examined.
Orbit part 2
The orbit is separated from the eyelid by the orbital septum, which prevents spread of infection from the eyelids to the orbit. Preseptal cellulitis involves infection of tissues anterior to the septum, causing eyelid swelling and pain but no orbital involvement. Orbital cellulitis is infection behind the septum in the orbit, which can lead to complications like abscesses, cavernous sinus thrombosis, or meningitis if not treated promptly with IV antibiotics. Cavernous sinus thrombosis involves septic thrombosis of the cavernous sinus veins and can cause bilateral proptosis, cranial nerve palsies, and systemic symptoms. Facial trauma can cause fractures of the orbital walls which may require surgical
COMPLICATIONS OF SINUSITIS ENT ..pptx
Sinusitis can lead to several intracranial and extracranial complications. Intracranial complications include meningitis, encephalitis, extradural abscess, subdural abscess, brain abscess, and cavernous sinus thrombosis which occur due to the spread of infection from paranasal sinuses to the brain. Extracranial complications include descending infections that can cause otitis media, pharyngitis, tonsillitis, laryngitis, and tracheobronchitis. Sinusitis may also act as a focus of infection leading to conditions like polyarthritis, tenosynovitis, and fibrositis.
Epistaxis
Epistaxis, or nosebleed, is bleeding from inside the nose. It is common and can occur in people of all ages. The nose has a rich blood supply from both the internal and external carotid arteries, making it susceptible to bleeding. The most common site of bleeding is Kiesselbach's plexus in the anterior nasal septum. Epistaxis can be classified as anterior or posterior depending on the location and direction of bleeding. Causes include local trauma, infections, vascular abnormalities, and medications. Management involves first aid measures, cauterization, nasal packing, surgery, or ligation of vessels supplying the nose.
Granulomatous diseases of nose
This document provides an overview of granulomatous diseases of the nose, including their classification, signs and symptoms, diagnosis, and treatment. Key points include:
1. Granulomatous diseases of the nose are classified as infective, inflammatory, or neoplastic. Common infective causes include tuberculosis, leprosy, and syphilis.
2. Tuberculosis can cause nasal obstruction, discharge, pain, and septal perforation. Leprosy may result in atrophic rhinitis and saddle nose deformity. Syphilis can cause gummatous lesions and saddle nose.
3. Diagnosis involves history, imaging, biopsy, and specialized staining or cultures. Treatment consists
Similar to Lateral sinus thrombophlebitis (20)
Complications of csom Dr.sithanandha Kumar,29.02.2016
Complications of csom Dr.sithanandha Kumar,29.02.2016
Complications of csom dr.sithanandha kumar,29.02.2016
Complications of csom dr.sithanandha kumar,29.02.2016
Complications of csom dr.sithanandha kumar 29.02.2016
Complications of csom dr.sithanandha kumar 29.02.2016
Lateral sinus thrombloplebitis and otitic hydrocephalus
Lateral sinus thrombloplebitis and otitic hydrocephalus
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Lateral sinus thrombophlebitis
- 2. Lateral sinus thrombophlebitis Inflammation of inner wall of lateral venous sinus (sigmoid sinus and transverse sinus) with the formation of intrasinus thrombus
- 3. Etiology Occurs as a complication of acute coalescent mastoiditis masked mastoiditis or chronic suppuration of middle ear and cholesteatoma Bacteria: In acute: hemolytic streptococcus, pneumococcus or staphylococcus In chronic: bacillus proteus,pseudomonas pyocyaneus,E.coli and staphylococci
- 4. Pathogenesis Formation of perisinus abscess (either by bony erosion of bony dural plate overlying sinus or by thrombosis of emissary vein) Endophlebitis mural thrombus formation Occlusion of sinus lumen intrasinus abscess Extension of infected thrombus
- 6. Extension of thrombus • Proximal: confluence of sinus, superior sagittal sinus, cavernous sinus • Distal : mastoid emissary vein to jugular bulb and jugular vein
- 7. Clinical features • Hectic picket fence fever with rigors: high fever, irregular, one or more spikes per day Each spike is due to release of fresh septic embolus Fever accompained by chills and rigors Temperature subsides with sweating • Headache • Anemia and emaciation
- 8. Clinical features……. • Griesinger’s sign: edema over posterior part of mastoid due to thrombosis of mastoid emissary vein • Papilloedema: blurring of disc margins, retinal hemorrhages or dilated veins in fundoscopy • Tenderness along jugular vein
- 9. Some tests Tobey-Ayer test: compression of I.J.V. rapid rise of C.S.F. pressure (50 – 100 mm water rapid fall on release of compression. In thrombosed side no rise. Crowe - Beck test: pressure on I.J.V. on normal side engorgement of retinal veins + papilloedema seen in fundoscopy due to lateral sinus thrombosis on opposite side.
- 11. Investigations • Blood smear: to rule out malaria • Blood culture • CSF analysis: normal except for rise in pressure • Imaging Contrast enhanced CT scan Contrast enhanced MRI MR venography • Culture and sensitivity of ear swab Delta sign
- 12. Delta sign(red arrow): traingular area with rim enhancement and central low density area
- 13. Complications • Septicemia and abscess in lung,bone,joints, or subcutaneous tissue • Meningitis and subdural abscess • Cerebellar abscess • Thrombosis of jugular bulb and jugular vein with associated cranial nerves involvement • Cavernous sinus thrombosis: proptosis,fixation of eyeball, and papilloedema • Otitic hydrocephalous
- 14. Treatment • Urgent complete cortical or modified radical mastoidectomy: Sinus wall incised. Infected clots removed & abscess drained • Antibiotics: broad spectrum antibiotics. Can be changed once culture and sensitivity report is available. Should be continued at least for a week after operation • Anticoagulants: in cavernous sinus thrombosis
- 15. 4. Internal jugular vein ligation: for embolism not responding to antibiotics & surgery 5. Blood transfusion: for anaemia
- 16. Otitic hydrocephalous Increase in CSF pressure in the presence of acute or chronic otitis media not secondary to brain abscess or meningitis, almost exclusively associated with sigmoid sinus thrombosis.
- 17. Etiology :1. Associated lateral sinus thrombosis obstruction of cerebral venous return. 2. Superior sagittal sinus thrombosis ed C.S.F. absorption Both of these factors result in raised ICP
- 18. Clinical features • Symptoms 1. Severe headache,nausea and vomiting 2. Diplopia involving VI cranial nerve 3. Blurring of vision • Signs 1. Papilloedema with hemorrhages 2. Nystagmus 3. CSF pressure rises(>300 mm H2O)
- 19. TREATMENT 1. Treating L.S.T 2. reducing CSF pressure: • I.V. Dexamethasone 4mg Q6H • I.V. 20% Mannitol 0.5 gm/kg • Repeated lumbar puncture / lumbar drain • Ventriculo-peritoneal shunt
- 20. References: • Dhingra ENT and head and neck surgery • Ballenger’s otorhinolaryngology17 head and neck surgery