An 8-year-old boy with untreated chronic suppurative otitis media develops high fever, vomiting and papilloedema. Imaging shows thrombosis of a dural venous sinus that grooves the inner surface of the mastoid part of the temporal bone. Which sinus is involved?

• A Cavernous sinus
• B Sigmoid sinus ✓
• C Inferior petrosal sinus
• D Sphenoparietal sinus

Explanation

Lateral sinus thrombosis is a classic intracranial complication of middle ear infection because the sigmoid sinus lies in a deep groove on the mastoid part of the temporal bone, directly behind and medial to the mastoid air cells. Extension of infection erodes the sinus plate and seeds the sinus lumen, producing raised intracranial pressure, sometimes called otitic hydrocephalus when thrombosis is bilateral. Cavernous sinus thrombosis follows facial or paranasal sepsis, not otitis media.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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Written and medically reviewed by the StethoPrep medical team.