Internal jugular vein thrombosis associated with acute mastoiditis in a pediatric age.

OBJECTIVE: To discuss the clinical aspects and management of internal jugular vein thrombosis associated with acute otitis media. STUDY DESIGN: Case reports and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT: The authors describe two cases of internal jugular vein thrombosis, without sigmoid sinus thrombosis, secondary to acute otomastoiditis. INTERVENTION: Jugular vein thrombosis was diagnosed in both cases by observation of filling defects of the involved jugular bulb on contrast-enhanced computed tomography and confirmed by conventional magnetic resonance and magnetic resonance venography. RESULTS: Both patients recovered after recanalization of the vessel concomitant to anticoagulation and antibiotic treatment associated with a simple mastoidectomy. CONCLUSION: Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.