J Korean Assoc Oral Maxillofac Surg.  2017 Oct;43(5):351-355. 10.5125/jkaoms.2017.43.5.351.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

• Aggarwal K
• Rastogi S
• Joshi A
• Kumar A
• Chaurasia
• Prakash R

• KMID: 2393602
• DOI: http://doi.org/10.5125/jkaoms.2017.43.5.351

Abstract

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

Keyword

Tooth extraction; Infection; Cavernous sinus thrombosis; Chemosis; Unregistered dental practitioner

MeSH Terms

Adult
Anti-Bacterial Agents
Anti-Infective Agents
Cavernous Sinus Thrombosis*
Cavernous Sinus*
Dilatation
Diplopia
Drainage
Early Diagnosis
Ecchymosis
Emergency Service, Hospital
Female
Health Education, Dental
Heparin
Humans
Mortality
Rare Diseases
Tooth Extraction
Veins
Anti-Bacterial Agents
Anti-Infective Agents
Heparin

Figure

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  Fig. 1 Diffuse swelling over the right side of the face involving the temporal and buccal spaces and necrosis over the right infraorbital region.

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  Fig. 2 Diplopia, dilated pupil, proptosis, periorbital ecchymosis, and chemosis of the right eye.

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  Fig. 3 Palatal necrosis.

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  Fig. 4 Venous dilatation of the right superior ophthalmic vein, suggestive of thrombosis.

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