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Management of Otogenic Sigmoid Sinus Thrombosis: A Systematic Review on the Role of Anticoagulation and its Outcome

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Abstract

To provide a systematic review on the use of additional anticoagulation in the management of otogenic sigmoid sinus thrombosis when compared with the cohort not receiving the anticoagulation. A systematic review until 2021 was done and relevant studies were screened. Based on a selective criteria, a database is constituted which were then rearranged and studied. 16 articles were selected with 113 patients. The group who received anticoagulation had more complications (23.33%) in comparison (21.74%), whereas the recanalization was successful in the anticoagulated group, 76.67%, as against 39.13%. In 74/90 patients who underwent mastoidectomy with anticoagulation, the recanalization and complication were 72.97% and 25.68% respectively. The second group with 16/90 patients who received conservative treatment, the recanalization and complication rates were 93.75% and 12.50% respectively. The third group with 23 patients were treated with mastoidectomy and antibiotics but didn’t receive anticoagulants in which the recanalization achieved in 39.13% with a complication rate of 21.74%. For those patients who underwent mastoidectomy with concurrent anticoagulation, 44 showed radiological evidence of recanalization, and in sixteen patients that received the same treatment, no recanalization was achieved whereas in patients who received conservative treatment with anticoagulation, 12 patients showed recanalization and finally, for the patients underwent surgery without anticoagulation, five patients achieved recanalization and 7 did not become recanalized (14.29%). Recanalization seems more pronounced in those who were anticoagulated, but, did not seem to influence the clinical outcome. Complications were more in those who were undergone surgery with or without anticoagulation.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. ENT Service, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

    Mercy George, Elio Torrigiani & Maire Raphael

  2. ENT, Department of Surgery, Sultan Qaboos University Hospital, P O 38, PC 123, Al Khoud, Oman

    Arif Ali Kolethekkat

  3. University Hospital Southampton, NHS, Hampshire, UK

    Sam S. Marston & Cynthia M. Thomas

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  1. Mercy George
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  2. Arif Ali Kolethekkat
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  3. Elio Torrigiani
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  4. Sam S. Marston
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  6. Maire Raphael
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Correspondence to Arif Ali Kolethekkat.

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George, M., Kolethekkat, A.A., Torrigiani, E. et al. Management of Otogenic Sigmoid Sinus Thrombosis: A Systematic Review on the Role of Anticoagulation and its Outcome. Indian J Otolaryngol Head Neck Surg 75, 450–456 (2023). https://doi.org/10.1007/s12070-022-03289-6

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  • DOI: https://doi.org/10.1007/s12070-022-03289-6

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