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1.
Article in Chinese | MEDLINE | ID: mdl-38297856

ABSTRACT

Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor(PPT). Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.


Subject(s)
Frontal Sinusitis , Pott Puffy Tumor , Humans , Pott Puffy Tumor/complications , Retrospective Studies , Tomography, X-Ray Computed , Endoscopy/adverse effects , Postoperative Complications , Anti-Bacterial Agents/therapeutic use , Frontal Sinusitis/complications
2.
Arch Argent Pediatr ; 122(4): e202310151, 2024 08 01.
Article in English, Spanish | MEDLINE | ID: mdl-38270557

ABSTRACT

A rare complication of frontal sinusitis includes Pott's puffy tumor. It manifests as a swelling of the forehead due to the presence of a subperiosteal abscess secondary to osteomyelitis of the frontal bone. A timely diagnosis allows for an early, intensive medical and surgical treatment, which is critical to prevent serious intracranial complications. Here we describe the case of a 12-year-old boy with Pott's puffy tumor as a complication of pansinusitis. This case was a diagnostic challenge; however, a timely treatment allowed for a favorable clinical course.


Una complicación infrecuente de la sinusitis frontal es el tumor inflamatorio de Pott. Se manifiesta como una tumefacción en la frente por la presencia de un absceso subperióstico secundario a una osteomielitis del hueso frontal. El diagnóstico oportuno permite un tratamiento intensivo médico y quirúrgico precoz, esencial para evitar complicaciones intracraneales graves. Se presenta el caso de un varón de 12 años con un tumor inflamatorio de Pott como complicación de una pansinusitis. Representó un desafío diagnóstico; sin embargo, la instauración del tratamiento oportuno permitió una evolución clínica favorable.


Subject(s)
Frontal Sinusitis , Pott Puffy Tumor , Humans , Pott Puffy Tumor/diagnosis , Pott Puffy Tumor/etiology , Pott Puffy Tumor/complications , Male , Child , Frontal Sinusitis/complications
3.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-1011108

ABSTRACT

Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor(PPT). Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.


Subject(s)
Humans , Pott Puffy Tumor/complications , Retrospective Studies , Tomography, X-Ray Computed , Endoscopy/adverse effects , Postoperative Complications , Anti-Bacterial Agents/therapeutic use , Frontal Sinusitis/complications
4.
Mil Med ; 188(11-12): 3696-3698, 2023 11 03.
Article in English | MEDLINE | ID: mdl-37489872

ABSTRACT

Pott's puffy tumor (PPT) describes forehead swelling with associated frontal bone osteomyelitis and a subperiosteal abscess (SPA) requiring a high suspicion index for optimal outcomes. PPT is a life-threatening complication of frontal sinusitis typically found in adolescents. Our case is one of the youngest in the literature. This report describes a 3-year-old patient who developed multifocal abscesses in the epidural space with frontal and orbital SPA, requiring surgical intervention. Additionally, her course was complicated by a superior sagittal venous thrombosis, a complication commonly associated with PPT. We present an unusual case of orbital SPA and aim to highlight a life-threatening pediatric condition that is often underrecognized.


Subject(s)
Frontal Sinusitis , Orbital Cellulitis , Pott Puffy Tumor , Humans , Adolescent , Child , Female , Child, Preschool , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnosis , Abscess/complications , Abscess/diagnosis , Frontal Sinusitis/complications , Frontal Sinusitis/diagnosis , Orbital Cellulitis/complications , Edema/complications
5.
BMC Pediatr ; 23(1): 300, 2023 06 17.
Article in English | MEDLINE | ID: mdl-37328772

ABSTRACT

BACKGROUND: Pott's puffy tumor (PPT) is a rare and potentially deadly complication of frontal sinusitis consisting of subperiosteal abscess and osteomyelitis of the frontal bone. CASE PRESENTATION: We report the case of a 9-year-old boy who presented with fever and soft tissue swelling of the forehead. Magnetic resonance imaging (MRI) depicted an abscess in the subcutaneous tissue frontally and an epidural empyema, while a cranial computed tomography (CT) scan revealed bone erosion as a sign of osteomyelitis. The patient was treated accordingly. CONCLUSIONS: This rare condition is essential to keep in mind as it needs a multidisciplinary approach and relevant imaging to start proper treatment and thus decrease the risk of intracranial complications.


Subject(s)
Frontal Sinusitis , Neoplasms , Pott Puffy Tumor , Male , Humans , Child , Pott Puffy Tumor/etiology , Pott Puffy Tumor/complications , Abscess/diagnostic imaging , Abscess/etiology , Forehead , Frontal Sinusitis/complications , Neoplasms/complications
7.
Surv Ophthalmol ; 68(4): 830-833, 2023.
Article in English | MEDLINE | ID: mdl-36427561

ABSTRACT

A 10-year-old boy presented with headache, fever, left-sided ptosis, and right-sided forehead soft tissue swelling. There was no recent history of trauma or infection. The patient had a large, fluctuant mass on the right side of his forehead, upgaze restriction, left-sided ptosis, and bilateral optic disk edema. Magnetic resonance imaging of the brain showed a frontal bone extradural fluid collection superficial to the superior sagittal sinus in keeping with an epidural abscess. There were multiple venous thromboses and thickening and enhancement of the dura, compatible with meningitis. There was right sphenoid sinusitis. This patient had Potts puffy tumor, a rare diagnosis associated with a forehead swelling from frontal bone osteomyelitis and subperiosteal abscess. It is seen in the pediatric population in association with sinusitis or trauma. Antibiotics, anticoagulation, and acetazolamide were initiated, and the epidural abscess was evacuated. The symptoms and signs resolved with treatment.


Subject(s)
Epidural Abscess , Pott Puffy Tumor , Male , Humans , Child , Epidural Abscess/diagnosis , Epidural Abscess/complications , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnosis
10.
Am J Otolaryngol ; 43(5): 103529, 2022.
Article in English | MEDLINE | ID: mdl-35700606

ABSTRACT

PURPOSE: Pott's puffy tumor (PPT) is a rare clinical entity characterized by osteomyelitis of the frontal bone with subperiosteal abscess collection. The frequency of reported cases of PPT in the literature has increased in recent years. Previous reviews of PPT exist primarily in the form of small, retrospective case series and anecdotal case reports. Therefore, the aim of this study is to provide the literature's largest comprehensive, up-to-date review of the essential clinical findings, diagnostic modalities, microbiologic considerations, and treatment approaches utilized in the management of PPT, both in pediatric and adult populations. MATERIALS AND METHODS: We searched MEDLINE, PubMed, and Embase databases for English-language studies published from January 1950 through January 30, 2022. The authors reviewed all cases of PPT, focusing specifically on those describing therapeutic management of PPT. A total of 321 patients were included, consisting of 318 patients (from 216 articles) and an additional 3 adult cases from our institution. RESULTS: PPT most often results from untreated rhinosinusitis, as well as direct head trauma, substance use, and odontogenic disease. Infections are classically polymicrobial with an anaerobe-predominant microbiome. Both CT and MRI imaging modalities are commonly obtained for presurgical assessment of sinusitis and intracranial extension. The core of treatment is an early and aggressive approach to prevent long-term complications. A significant association exists between surgical management and clinical outcomes for patients with PPT. Recent literature suggests endoscopic sinus surgery is essential for successful disease resolution. CONCLUSIONS: PPT is an important and relatively morbid disease process that is often underrecognized and misdiagnosed at presentation due to its variable clinical presentation. Management of PPT includes both antimicrobial therapy and surgical intervention. Determination of the optimal approach depends on patient clinical features including age, history of prior endoscopic sinus surgery, and presence of intracranial involvement on presentation. An individualized, targeted, and interdisciplinary approach to the treatment of PPT is critical for successful disease resolution.


Subject(s)
Pott Puffy Tumor , Sinusitis , Abscess/diagnosis , Abscess/etiology , Abscess/therapy , Adult , Child , Humans , Magnetic Resonance Imaging/adverse effects , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnosis , Pott Puffy Tumor/therapy , Retrospective Studies , Sinusitis/complications
11.
BMJ Case Rep ; 15(3)2022 Mar 04.
Article in English | MEDLINE | ID: mdl-35246435

ABSTRACT

Pott's puffy tumour (PPT) is a rarely seen, but highly important, complication of frontal sinusitis. Early recognition followed by prompt imaging and treatment of this condition are essential to improve patient outcomes and prevent complications. This case report describes an atypical presentation of radiologically confirmed PPT in a boy who presented with a 2.5-week history of progressive frontal headache and midline frontal swelling. Flexible nasendoscopy revealed no acute findings. Prompt CT imaging confirmed the diagnosis and early surgical intervention via endoscopic approach with aggressive antibiotic therapy led to good recovery. This case highlights the need to remember PPT in assessing any child or adolescent with a new forehead swelling, with or without sinusitis symptoms. If there is strong clinical suspicion, further imaging should not be delayed. Surgical intervention should be performed as early as possible to prevent intracranial complications; antibiotics alone are not sufficient.


Subject(s)
Frontal Sinusitis , Pott Puffy Tumor , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Edema/complications , Endoscopy/adverse effects , Frontal Sinusitis/diagnosis , Frontal Sinusitis/diagnostic imaging , Humans , Male , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnostic imaging
12.
Ear Nose Throat J ; 101(4): NP186-NP188, 2022 May.
Article in English | MEDLINE | ID: mdl-32921154

ABSTRACT

Pott's puffy tumor (PPT) is a nonneoplastic complication of acute frontal sinusitis characterized by subperiosteal abscess (SPOA) formation and osteomyelitis. Although various clinical conditions are associated with frontal SPOA, cases associated with odontogenic sinusitis are rare. We report a recurrent case of frontal SPOA who had a previous history of craniotomy due to head trauma. The patient was presented with headache, facial swelling and diagnosed as frontal, ethmoid, and maxillary sinusitis with frontal SPOA, which is PPT. The patient was surgically managed by endoscopic sinus surgery and external drainage of the abscess. Although the symptoms had been relieved soon after the surgery, they were recurred after 1 week. By paranasal sinus computed tomography scans, it was suspected that severe carious teeth, which were missed before surgery, induced maxillary sinusitis which spread into the frontal sinus and subperiosteal areas inducing recurrence of disease. Our experience suggests that frontal SPOA may originate from odontogenic maxillary sinusitis caused by severe dental caries, which should be actively managed, especially in patients with the risk of spread of inflammation, such as those who have discontinuity in frontal bone.


Subject(s)
Dental Caries , Frontal Sinus , Frontal Sinusitis , Maxillary Sinusitis , Pott Puffy Tumor , Abscess/etiology , Dental Caries/complications , Frontal Sinus/surgery , Frontal Sinusitis/complications , Frontal Sinusitis/diagnostic imaging , Humans , Maxillary Sinusitis/complications , Pott Puffy Tumor/complications
13.
Auris Nasus Larynx ; 49(4): 713-716, 2022 Aug.
Article in English | MEDLINE | ID: mdl-33422370

ABSTRACT

This case report describes a child who developed Pott's puffy tumor and was treated at the Children's Mercy Hospital in Kansas City. In addition to a discussion of a case, a review of the literature was completed on this topic describing the typical embryology and development of the frontal sinus, and the epidemiology, diagnosis, and treatment of Pott's puffy tumor. The patient was a 23-month-old boy who developed Pott's puffy tumor after recovery from influenza. The patient presented to the hospital with progressing edema of the unilateral eye that spread bilaterally within a few days. A CT scan demonstrated pansinusitis, developed frontal sinuses, right periorbital cellulitis, and medial forehead subperiosteal abscess. Functional endoscopic sinus surgery and transcutaneous abscess drainage were urgently performed and the patient made a full recovery following a course of ertapenem and levofloxacin. The presence of a developed frontal sinus in a 23-month-old is an unexpected radiologic finding. This case represents the youngest patient reported in the literature to develop this rare complication of frontal sinusitis.


Subject(s)
Frontal Sinus , Frontal Sinusitis , Pott Puffy Tumor , Abscess/complications , Abscess/diagnostic imaging , Abscess/therapy , Frontal Sinus/diagnostic imaging , Frontal Sinus/surgery , Frontal Sinusitis/complications , Frontal Sinusitis/diagnostic imaging , Humans , Infant , Male , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnostic imaging , Pott Puffy Tumor/therapy , Rare Diseases/complications , Rare Diseases/pathology
14.
Ear Nose Throat J ; 100(6_suppl): 870S-872S, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34414793

ABSTRACT

Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be managed with a combination of open and endoscopic sinus surgery and intravenous antibiotic therapy. In the current report, a 15-year-old male presented with a classic case of Pott's puffy tumor which was managed with bilateral ethmoidectomies, frontal sinusotomies, and frontal sinus trephination, resulting in discharge on intravenous antibiotic therapy and subsequent complete resolution of symptoms.


Subject(s)
Frontal Bone/diagnostic imaging , Pott Puffy Tumor/diagnostic imaging , Abscess/etiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Edema/etiology , Erythema/etiology , Ethmoid Sinus/surgery , Frontal Bone/surgery , Frontal Sinus/surgery , Humans , Male , Pott Puffy Tumor/complications , Pott Puffy Tumor/drug therapy , Pott Puffy Tumor/surgery , Trephining
17.
J Craniofac Surg ; 31(4): e418-e420, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32310872

ABSTRACT

Pott's puffy tumor (PPT) is a rare subperiosteal abscess of the frontal bone with osteomyelitis, which most commonly affects adolescents as a complication of frontal sinusitis or head trauma. The Authors describe a case of development of a PPT in a woman who abused of cocaine for at least five years and presented with a gradually enlarging mass of the forehead. The patient was treated surgically through combined endoscopic and open approach and medically with antibiotic therapy. The PPT, as rare complication of intranasal cocaine abuse, was described until now in four patients. Even rare it can be a fearsome complication, making of fundamental importance an early diagnosis and a correct management.


Subject(s)
Cocaine-Related Disorders/complications , Nose Neoplasms/diagnostic imaging , Pott Puffy Tumor/diagnostic imaging , Administration, Intranasal , Anti-Bacterial Agents/therapeutic use , Female , Humans , Middle Aged , Nose Neoplasms/complications , Pott Puffy Tumor/complications
18.
Laryngoscope ; 130(1): 225-231, 2020 01.
Article in English | MEDLINE | ID: mdl-30570150

ABSTRACT

OBJECTIVES: Pott's puffy tumor (PTT) is a frontal subperiosteal abscess associated with underlying frontal osteomyelitis. The purpose of the present study was to assess the rate of intracranial involvement in pediatric and adolescent patients with PPT and to discuss the diagnostic workup and the therapeutic features of this pathology. METHODS: We searched Web of Science, PubMed and MEDLINE from 1998 to 2018. The search focused on papers concerning the diagnostic procedure and therapeutic management of PTT. Statistical techniques were not used. RESULTS: We included 53 articles that described 92 pediatric and adolescent patients with PPT. The overall rate of intracranial complications was found to be 72%. Most authors used computed tomography for the diagnosis of PTT and its complications, either alone or in combination with magnetic resonance imaging. In 50% of cases, an endoscopic endonasal approach is used for the management of the underlying acute or chronic sinusitis. CONCLUSIONS: On the basis of the available literature, it seems that the incidence rate of intracranial involvement in patients with PPT is quite high. Early diagnosis using the appropriate imaging raise the possibility of good recovery. Concerning the therapy of PTT, endoscopic sinus surgery could be considered as a valuable technique. The vast majority of patients treated appropriately recover without long-term neurologic complications and sequelae. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:225-231, 2020.


Subject(s)
Pott Puffy Tumor , Adolescent , Brain Diseases/etiology , Child , Child, Preschool , Humans , Infant , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnosis , Pott Puffy Tumor/therapy
20.
BMJ Case Rep ; 12(7)2019 Jul 16.
Article in English | MEDLINE | ID: mdl-31315845

ABSTRACT

Pott's puffy tumour (PPT) is a known complication of frontal sinusitis. It is defined as subperiosteal abscess formation due to osteomyelitis of the frontal bone presenting as a forehead swelling. It is a life-threatening condition that can lead to intracranial and intraorbital complications. Gadolinium-enhanced MRI and contrast CT scan are the best modalities to localise and define the collection, in addition to confirming disease extension. Once confirmed by imaging and depending on disease extension, management of PPT requires a multidisciplinary team approach and depends on the local provision of surgical care. Following surgical drainage of the abscess cavity, a prolonged course of antibiotics is required postoperatively to treat the underlying osteomyelitis.


Subject(s)
Abscess/drug therapy , Frontal Bone/pathology , Pott Puffy Tumor/complications , Abscess/surgery , Administration, Intravenous , Adolescent , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Frontal Sinusitis/diagnostic imaging , Frontal Sinusitis/microbiology , Frontal Sinusitis/pathology , Humans , Magnetic Resonance Imaging , Male , Orbital Cellulitis/etiology , Orbital Cellulitis/pathology , Osteomyelitis/pathology , Tomography, X-Ray Computed , Treatment Outcome
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