Clinical Note |

Superior Ophthalmic Vein Thrombosis:  Complication of Ethmoidal Rhinosinusitis

Leonard Berenholz, MD, FACS; Alexander Kessler, MD; Nathan Shlomkovitz, MD; Shlomo Sarfati, MD; Samuel Segal, MD
Arch Otolaryngol Head Neck Surg. 1998;124(1):95-97. doi:10.1001/archotol.124.1.95.
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Complications of rhinosinusitis are fortunately rare. The progression from the initial stage of cellulitis to orbital abscess, cavernous sinus thrombosis, or meningitis may at times be quite rapid. Prompt treatment with intravenous antibiotics and a high index of suspicion are critical in the management of these cases. Computed tomography (CT) is the standard radiographic examination performed initially and subsequently to diagnose complications. Thickening of the superior ophthalmic vein should be looked for as an important radiologic marker of impending orbital complications, such as cavernous sinus thrombosis. We describe a patient with superior ophthalmic vein thrombosis seen early on CT scan.

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Figure 1.

Clinical picture with progressive orbital symptoms.

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Figure 2.

Computed tomographic scan demonstrating right superior ophthalmic vein thrombosis.

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Figure 3.

Pathway of venous drainage to cavernous sinus.

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