Question: A 4 year old boy is evaluated for ear proptosis in the setting of acute otitis media. Imaging reveals a flow void within the sigmoid sinus extending from the transverse sinus to jugular bulb. The patient had no evidence of hydrocephalus. Spiking fevers were noted but at the time of evaluation the patient was afebrile. What is the most appropriate management?

a) PE tube, mastoidectomy, sigmoid sinus decompression

b) PE tube alone

c) IV antibiotics and deferring surgery for consistent fevers

d) IV antibiotics, anticoagulation, and deferring surgery for consistent fevers

[Answer will be posted with next week's new question]

Answer to last week's question, “Deep Inspiration" (January 20, 2020)

C - Inhaled long-acting beta agonists.