Abstract
PurposeSeptic cavernous sinus thrombosis (CST) is a rare complication of infections in the head and neck area. CST is notorious for its bad prognosis, with high mortality and morbidity rates described in literature. However, these rates are based on old series. We question whether the prognosis of CST is currently still as devastating. The primary purpose of this study is to assess the mortality and morbidity of CST.MethodsUsing the databases of all relevant specialties in our tertiary referral hospital, we collected all the patients treated for CST in the period 2005–2017. In addition, a PubMed search, using the mesh term ‘cavernous sinus thrombosis’, was performed.ResultsWe found 12 patients with CST in the study period. Of the 12 patients, 11 survived and 9 recovered without any permanent deficits. Seven patients were treated with anticoagulation, and in none of the patients we saw hemorrhagic complications. In literature, older articles describe higher mortality rates (14–80%), but more recent articles report mortality and morbidity rates similar to our results.ConclusionsThe prognosis of CST nowadays is more favorable than previously described. Anticoagulation seems to be a safe addition to antibiotic and surgical treatment, at least in patients without central nervous system infection.
Highlights
Septic cavernous sinus thrombosis (CST) is known as a rare, life-threatening complication of infections in the head and neck area
Twelve patients were admitted with CST in our institute in the study period
Other presenting signs and symptoms were related to the source of infection and included sore throat, trismus, otalgia, and headache
Summary
Septic cavernous sinus thrombosis (CST) is known as a rare, life-threatening complication of infections in the head and neck area. The use of antibiotics has improved the prognosis, CST is still notorious for its high mortality and morbidity rates. The paranasal sinuses are the most common. We present 12 cases of CST of varying origins and discuss the clinical presentation, treatment and outcomes with a multidisciplinary scope. The purpose of this study is to study the mortality and morbidity of CST in our tertiary referral center and to evaluate the effect of treatment with anticoagulants. We discuss our findings within the context of the past and current literature
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