Introduction And Importance: Frontal bone osteomyelitis associated with a subperiosteal abscess is known as Pott's puffy tumor. Pott puffy tumor (PPT) is a rare entity that mainly affects children and adolescents. It is less common in adults, accounting for 30 % of cases, and predominates in men. The therapeutic management of Pott's puffy tumor is an emergency and is based on a combination of antibiotic therapy and surgical treatment to prevent the emergence of intracranial complications and reduce morbidity and mortality.
Case Presentation: We report the case of a 29-year-old female patient, who consulted our ENT (ear, nose, and throat) department for a post-traumatic periorbital swelling. CT scan confirmed osteomyelitis of the frontal bone and subperiosteal abscess. The patient underwent a combined surgical drainage with antibiotics. The aim is to describe an effective management of this clinical case.
Clinical Discussion: This condition presents as a subperiosteal/subgaleal abscess creating a frontal swelling, with osteomyelitis of the frontal bone most often secondary to frontal sinusitis. The most feared complications are intracranial, which can be life-threatening. Imaging is the key to positive diagnosis, as the evolution and prognosis of TPP depend on rapid management. A CT scan of the head is the examination of choice to confirm the diagnosis. Antibiotic therapy should be started as soon as possible, it is usually administered by intravenous injection. Surgical management may be limited to percutaneous drainage by needle or transnasal endoscopy or trephination, sometimes including trimming of the subperiosteal/subgaleal abscess. In the case of intracranial complications, a craniotomy may be necessary.
Conclusion: The Pott's puffy tumor is little-known complication, usually secondary to untreated or poorly treated sinusitis. As a result of this poor understanding, the condition can lead to complications, especially intracranial ones, which increase morbidity and mortality.
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http://dx.doi.org/10.1016/j.ijscr.2024.110241 | DOI Listing |
Radiologia (Engl Ed)
December 2024
Departamento de Otorrinolaringología, Cirugía de Cabeza y Cuello, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
Acute rhinossinusitis is defined as a symptomatic inflammation of the nasal fossa and paranasal sinuses. The diagnosis of this disease is clinical and usually does not require imaging evaluation. However, when there is a suspicion of a complication or even for surgical planning, imaging is of primordial importance.
View Article and Find Full Text PDFPediatr Emerg Care
December 2024
Point-of-care ultrasound (POCUS) has been useful in describing soft tissue infections, such as cellulitis and abscesses. There has been limited use of ultrasound to describe findings of intracranial infections, such as Pott's puffy tumor, in cases of forehead prominence and signs of infection. In this case series we present POCUS findings in 2 cases of intracranial infections and one case of soft tissue edema without intracranial involvement from a single pediatric tertiary care center.
View Article and Find Full Text PDFRadiol Case Rep
January 2025
Department of Radiology, Ibn Jazzar Regional Hospital (Kairouan), Faculty of Medicine of Sousse, Tunisia.
Pott Puffy Tumor (PPT) is extremely rare, yet potentially severe condition characterized by osteomyelitis of the frontal bone associated with one or multiple subperiosteal abscesses, primarily from nasosinusitis. It is characterized by localized frontal swelling accompanied by a subperiosteal abscess. Clinicians and radiologists do not widely recognize this complication of frontal sinusitis and, hence it is likely to be overlooked in clinical practice.
View Article and Find Full Text PDFInt J Pediatr Otorhinolaryngol
December 2024
The Hospital for Sick Children, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada, M5G 1X8. Electronic address:
Objective: This review aims to elucidate the role of endoscopic sinus surgery (ESS) on the outcomes of pediatric patients with sinogenic intracranial infections.
Methods: MEDLINE, Embase, and the Cochrane library were searched for articles that described the outcomes in pediatric patients who had intracranial complications of acute rhinosinusitis (ARS) and underwent ESS with or without open neurosurgical approaches (ONA) or external sinus approaches (ESA). Primary outcomes of interest include mortality, revision surgery, length of stay and neurological sequelae.
Intern Med
November 2024
Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan.
Pott's puffy tumor is a rare complication of frontal sinusitis characterized by frontal bone osteomyelitis with a subperiosteal abscess typically presenting with forehead swelling. We herein report a 21-year-old man with Pott's puffy tumor presenting as eyelid swelling on the opposite side of the sinusitis, without typical forehead swelling. Initially treated for sinusitis and pre-septal cellulitis with poor response, head magnetic resonance imaging revealed bilateral subdural abscesses and osteomyelitis of the frontal and bilateral parietal bones, leading to the diagnosis.
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