Publication date: Jul 22, 2024

Sinus thrombosis is a common post-operative finding after posterior fossa surgery performed in the vicinity of the dural venous sinuses. The SARS-CoV-2 virus has been shown to confer an increased risk of venous thromboembolic events owing to eliciting a hyper-inflammatory and pro-thrombotic state. In this study, we examine the incidence of post-operative venous sinus thrombosis in patients undergoing peri-sigmoid posterior fossa surgery in the pre- and post-COVID era and investigate whether COVID infection confers an increased risk of sinus thrombosis. A retrospective review of a single institution case series of patients underwent peri-sigmoid surgery (retrosigmoid, translabyrinthine, or far lateral) approach. Relevant clinical variables were investigated that may confer an increased risk of sinus thrombosis. A total of 311 patients (178 in the pre-COVID era, and 133 operated on after the pandemic began in March 2020) are included in the study. The composite incidence of sinus thrombosis seen on post-operative imaging was 7. 8%. The incidence of sinus thrombosis in the pre-COVID cohort was N = 12 patients (6. 7%) versus N = 12 (9%) in the post-COVID cohort (p = 0. 46). A history of COVID infection was not shown to confer an increased risk of post-operative sinus thrombosis (OR: 0. 61; 95% CI: 0. 08-4. 79, p = 0. 64). Only a small number of patients (N = 7, 2. 3%) required either medical or surgical intervention for post-operative sinus thrombosis. The overall incidence of post-operative sinus thrombosis is similar in the pre- and post-COVID era. The findings of this study suggest that COVID infection is not associated with a higher risk of venous sinus thrombosis.

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