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Datta D, Tu A. Pott's puffy tumor with intracranial extension in a child with incontinentia pigmenti: case based review of the eponymous disease. Childs Nerv Syst 2024:10.1007/s00381-024-06577-4. [PMID: 39180698 DOI: 10.1007/s00381-024-06577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Pott's puffy tumor (PPT) is an uncommon infection involving the frontal bone, first described by Sir Percival Pott more than 250 years ago. It can present with intracranial extension and serious neurological morbidity. Incontinentia pigmenti (IP) is a rare inherited genodermatosis that is lethal prenatally in males and manifests clinically in females. IP is associated with recurrent infections and immune dysfunction/suppression. METHODS We report a case of Pott's puffy tumor presenting in a child with IP. We also performed a literature review of reported cases of PPT associated with immune dysfunction. We discuss the clinical presentation, diagnosis, and management of these lesions. RESULTS We identified 12 cases of PPT associated with immune dysfunction/suppression. Diabetes was the most commonly identified cause followed by iatrogenic immunosuppression. Surgery is the standard treatment for managing PPT and the management of PPT with and without intracranial involvement, particularly in the context of underlying immune dysfunction/suppression, is discussed. CONCLUSION PPT remains a rare but not infrequent diagnosis, often requiring neurosurgical intervention. Immune dysfunction/suppression is an additional risk factor that may predispose to PPT. Early and aggressive management should be instituted for optimal outcome.
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Affiliation(s)
- Debajyoti Datta
- Division of Pediatric Neurosurgery, Children's Hospital of Eastern Ontario (CHEO), Rm 3359, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
- University of Ottawa, Ottawa, ON, Canada
| | - Albert Tu
- Division of Pediatric Neurosurgery, Children's Hospital of Eastern Ontario (CHEO), Rm 3359, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
- University of Ottawa, Ottawa, ON, Canada.
- CHEO Research Institute, CHEO, Ottawa, ON, Canada.
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2
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Tatsuki S, Tsuda T, Takeda K, Obata S, Inohara H. A Case of Pott's Puffy Tumor in a Patient With Eosinophilic Chronic Rhinosinusitis. Cureus 2024; 16:e60893. [PMID: 38910757 PMCID: PMC11193106 DOI: 10.7759/cureus.60893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
Eosinophilic chronic rhinosinusitis (ECRS) is a refractory type 2 inflammation-based airway allergic disease that is prone to complications such as bronchial asthma. Pott's puffy tumor (PPT) is a rare clinical entity characterized by osteomyelitis of the frontal bone accompanied by a subperiosteal abscess. A 56-year-old female with a history of cranial surgery and bronchial asthma presented to an otolaryngology clinic with nasal obstruction and loss of smell, later developing swelling and redness on her forehead. She was diagnosed and treated for ECRS and was thought to have developed PPT during her course. Nasal endoscopy reveals bilateral polyp formation originating from the middle meatus. Paranasal computed tomography (CT) indicates substantial swelling extending from the opening of the frontal sinus to the adjacent subcutaneous tissue, accompanied by a defect in the frontal bone and osteolysis at the base of the frontal skull. Her management included conservative antibiotic therapy adjusted due to a drug eruption and, subsequently, endoscopic sinus surgery (ESS). The case was complicated by the patient's medical history and the absence of detailed surgical records, which limited the use of enhanced imaging techniques. This underscores the complexity of diagnosing and managing PPT in adults, particularly those with prior surgeries, emphasizing the need for a tailored diagnostic and therapeutic approach that integrates detailed patient history with current clinical indicators to effectively guide treatment. This case contributes to the limited literature on adult PPT and underscores the critical need for careful patient monitoring and detailed surgical history.
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Affiliation(s)
- Shuya Tatsuki
- Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN
| | - Takeshi Tsuda
- Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN
| | - Kazuya Takeda
- Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN
| | - Sho Obata
- Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN
| | - Hidenori Inohara
- Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN
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3
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Benfadil D, Rabhi M, Bellaouchi A, Lachkar A, Elayoubi F. Post-traumatic Pott's tumor in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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4
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Vanessa AB, Carlos RD, Tamara AC. Pott's tumor in adults, report of 2 cases in adults and review of the literature. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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5
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Bofares K, Haqqar Z, Ali I. Pott's puffy tumor: as a very rare and unpredicted complication of ipsilateral pan sinusitis - case presentation and review of articles. RHINOLOGY ONLINE 2021. [DOI: 10.4193/rhinol/21.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Pott's puffy tumor is considered as a rare clinical entity. It is developed as a rare complication of frontal sinusitis. In addition, the trauma to the frontal area is another suggested cause. The Pott's puffy tumor is presented as a forehead swelling due to sub-periosteal collection. Although, the Pott's puffy tumor is a rare condition but at the same time, it can be serious because it may lead to life threatening complications namely, extradural abscess, subdural abscess, meningitis, encephalitis, and brain abscess. Thus, the Pott's puffy tumor is classified as a very significant surgical emergency.
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6
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Milinis K, Thompson N, Atsmoni SC, Sharma SD. Sinogenic Intracranial Suppuration in Children: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2021; 167:215-223. [PMID: 34491863 DOI: 10.1177/01945998211043847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate temporal trends in the management of sinogenic intracranial suppuration and its outcomes in children. DATA SOURCES A systematic search of databases was performed (Medline, Embase, Cochrane, ClinicalTrials.gov). REVIEW METHODS Studies in children (age <18 years) with sinogenic subdural empyema, extradural abscess, and intraparenchymal abscess were included. Data on treatment strategies were extracted. Primary outcome was death <90 days. Secondary outcomes were return to theater, neurologic disability at 6 months, and length of stay. Random effects meta-analysis and meta-regression were performed to investigate the effect of time and endoscopic sinus surgery (ESS) on these outcomes. RESULTS A total of 32 retrospective observational studies involving 533 patients recruited across a 45-year period (1975-2020) were included. The pooled estimates for 90-day mortality, permanent neurologic disability, and return to theater were 2.3% (95% CI, 1.1%-3.6%; I2 = 0, P > .99), 21.3% (95% CI, 15.3%-27.3%; I2 = 75.2%, P < .001), and 37.3% (95% CI, 29.5%-45%; I2 = 71.2%, P < .001), respectively, with no significant differences found across the study period. The pooled estimate for ESS was 58.4% (95% CI, 44.2%-72.6%; I2 = 97.1%, P < .001) with a significantly increasing trend in its use in the more recent years. ESS was not associated with improved mortality, reduced need for revision surgery, or neurologic disability. CONCLUSION The outcomes of sinogenic intracranial complications have not changed over the last 45 years, and ESS was not associated with improved patient outcomes. Further high-quality studies are required to determine the most appropriate treatment modalities to improve the burden of morbidity associated with sinogenic intracranial suppuration in children.
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7
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Aiden AP, Boyd ME, Carey JM, Yusuf S. A Teenage Boy with Right Forehead Swelling Following Trauma to the Head. Pediatr Rev 2021; 42:S35-S38. [PMID: 33386358 DOI: 10.1542/pir.2019-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Aviva P Aiden
- Division of Pediatrics Emergency Medicine, Department of Pediatrics.,Department of Molecular & Human Genetics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.,Department of Bioengineering, Rice University, Houston, TX
| | - McKenna E Boyd
- Office of Student Affairs, Baylor College of Medicine, Houston, TX
| | - John M Carey
- Division of Pediatrics Emergency Medicine, Department of Pediatrics
| | - Shabana Yusuf
- Division of Pediatrics Emergency Medicine, Department of Pediatrics,
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Patel A, Vuppula S, Hayward H, Lakhani A, Lighter J. A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving. Pediatr Emerg Care 2021; 37:e51-e54. [PMID: 30601343 PMCID: PMC7774810 DOI: 10.1097/pec.0000000000001657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Barosinusitis, or sinus barotrauma, is a well-described condition associated with changes in barometric pressure during flight and diving that can result in sinonasal mucosal injury. In this case report, we present an adolescent who experienced barosinusitis during scuba diving and subsequently developed Pott's puffy tumor (PPT), characterized by frontal sinusitis, frontal bone osteomyelitis, and overlying subperiosteal abscess. This unique case of PPT following scuba diving provides the opportunity to review the pathophysiology of both barotrauma-induced sinus disease and PPT, a rare and unreported serious complication of barosinusitis. Furthermore, we discuss how scuba diving and associated barosinusitis can be considered a risk factor in the development of PPT.
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Affiliation(s)
- Ami Patel
- From the Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Langone Health, New York, NY
| | - Sharon Vuppula
- From the Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Langone Health, New York, NY
| | | | - Anisa Lakhani
- McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Jennifer Lighter
- From the Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Langone Health, New York, NY
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9
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Dayan ER, Sanders JE. Girl With Fever and Forehead Swelling. Ann Emerg Med 2020; 76:679-694. [PMID: 33097125 DOI: 10.1016/j.annemergmed.2020.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ezra R Dayan
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jennifer E Sanders
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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10
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Hu CY, Wu CT, Chen CC, Fu CH. Bicoronal Incision and Frontal-Basal Approach for Removal of Sinonasal Fibrous Dysplasia Complicated by Orbital Subperiosteal Abscess. World Neurosurg 2020; 143:389-391. [PMID: 32745647 DOI: 10.1016/j.wneu.2020.07.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/24/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Fibrous dysplasia (FD) is a benign, slowly progressive disease resulting from the replacement of normal bone by fibro-osseous tissue. The incidence of craniofacial involvement of FD is as high as 23%. Sinonasal involvement of FD may lead to obstruction of the natural sinus ostium, resulting in acute sinusitis. We present a rare case of sinonasal FD complicated by subperiosteal abscess that was removed by bicoronal incision and frontal-basal approach in the second surgery. CASE DESCRIPTION A 16-year-old male patient presented with painful swelling on his left eye that had persisted for 2 days. Transnasal endoscopic drainage of the left orbital subperiosteal abscess was performed and progressive improvement of the swelling of the left eye was noted. After the acute phase, transcranial removal of the sinonasal bony lesion and mesh reconstruction of the left orbital wall were performed. There has been no progression of FD to date, with 24 months of follow-up. CONCLUSIONS After the acute phase, radical excision with reconstruction or debulking surgery after skeletal maturation may prevent recurrence. Although malignant transformation is rare, long-term follow-up is necessary for FD.
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Affiliation(s)
- Chih-Yu Hu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chieh-Tsai Wu
- Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Medical Augmented Reality Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Chien-Cheng Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chia-Hsiang Fu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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11
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Pott’s puffy abscess: Moniker change from historical misnomer of Pott’s puffy tumor. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2019.100643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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12
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SALOM-COVEÑAS C, BENITO-NAVARRO JR, GUTIÉRREZ-GALLARDO A, PORRAS-ALONSO E. Tumor inflamatorio de pott. Descripción de un caso. REVISTA ORL 2020. [DOI: 10.14201/orl.23019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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13
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Treatment of pediatric extra-axial sinogenic infection: case series and literature review. Childs Nerv Syst 2020; 36:755-766. [PMID: 31773238 DOI: 10.1007/s00381-019-04378-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Analyze the clinical presentation, microbiology, outcomes, and medical and surgical treatment strategies of intracranial extension of sinogenic infection in pediatric patients. METHODS A retrospective, single-center study of patients < 18 years of age, presenting with intracranial extension of bacterial sinogenic infections requiring surgical intervention over a 5-year period, was conducted. Electronic medical records were reviewed for age, sex, primary symptoms, duration of symptoms, presence of sinusitis at initial presentation, microorganisms isolated, mode of surgery, timing of surgery, length of stay, and neurologic sequelae. RESULTS Seventeen patients were identified; mean age was 10 years with 82.3% male predominance. Average duration of illness prior to presentation was 9.8 days, with 64.7% of patients displaying disease progression while on oral antibiotics prior to presentation. Sinusitis and intracranial extension were present in all patients upon admission. Simultaneous endoscopic endonasal drainage and craniotomy were performed on 70.5% of the patients, with the remaining 29.5% undergoing endonasal drainage only. Of the patients who underwent simultaneous endoscopic endonasal drainage and craniotomy, 17.6% required repeat craniotomy and 5.8% required repeat sinus surgery. The most commonly isolated organisms were S. intermedius (52.9%), S. anginosus (23.5%), and S. pyogenes (17.6%). All patients were treated postoperatively antibiotic on average 4-6 weeks. Frequently occurring long-lasting complications included seizures (29.4%) and focal motor deficits (17.6%); learning disability, anxiety disorders, impaired cognition, and sensory deficits occurred less frequently. CONCLUSION In the case of intracranial extension of bacterial sinogenic infection, early identification and surgical treatment are crucial to avoid neurological sequelae.
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Nourkami-Tutdibi N, Linsler S, Yilmaz U, Pfeifer J, Derouet C, Becker SL, Zemlin M, Meyer S, Kulas P. A 6-Year-Old Boy with a Frontal Mass: Pott Puffy Tumor. J Pediatr 2020; 217:211. [PMID: 31679632 DOI: 10.1016/j.jpeds.2019.09.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | | | | | - Sören L Becker
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene
| | | | | | - Philipp Kulas
- Hospital for Otorhinolaryngology and Head and Neck Surgery, Saarland University, Homburg/Saar, Germany
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15
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Min HJ, Kim KS. Frontocutaneous Fistula Secondary to Pott's Puffy Tumor. EAR, NOSE & THROAT JOURNAL 2019; 99:NP101-NP102. [PMID: 31189353 DOI: 10.1177/0145561319856858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, 65542Chung-Ang University College of Medicine, Seoul, Korea
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, 65542Chung-Ang University College of Medicine, Seoul, Korea
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16
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Hasan I, Smith SF, Hammond-Kenny A. Potts puffy tumour: a rare but important diagnosis. J Surg Case Rep 2019; 2019:rjz099. [PMID: 30967934 PMCID: PMC6446532 DOI: 10.1093/jscr/rjz099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/24/2019] [Indexed: 11/21/2022] Open
Abstract
Potts puffy tumour (PPT) is a subperiosteal abscess arising from frontal bone osteomyelitis. We present a case of a 75-year-old lady with headache and a forehead swelling who was initially treated for sinusitis and giant cell arteritis in a primary care setting, but failed to improve. Following clinical deterioration and further investigation, CT appearances were consistent with a diagnosis of PPT and an extra-axial collection. Needle decompression, frontal trephine and endoscopic frontal sinusotomy were performed and intraoperative swabs cultured Streptococcus constellatus PPT is an unusual clinical entity that benefits from prompt antibiotic and surgical management, and therefore early recognition is paramount. We highlight that PPT should be a differential diagnosis in all patients presenting with forehead or frontal swelling. Use of radiological imaging (CT/MRI) is necessary to not only confirm a diagnosis of PPT but to identify further intracranial complications, which can be life-threatening.
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Affiliation(s)
- Ibtisam Hasan
- Department of Medicine, West Suffolk Hospital, Bury St Edmunds IP33 2QZ, UK
| | - Stephanie F Smith
- Department of General Surgery, West Suffolk Hospital, Bury St Edmunds IP33 2QZ, UK
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Koltsidopoulos P, Papageorgiou E, Skoulakis C. Pott's puffy tumor in children: A review of the literature. Laryngoscope 2018; 130:225-231. [PMID: 30570150 DOI: 10.1002/lary.27757] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 11/06/2022]
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.
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Affiliation(s)
| | - Eleni Papageorgiou
- Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
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19
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Abstract
Pott puffy tumor is osteomyelitis of the frontal bone with associated subperiosteal abscess causing swelling and edema over the forehead and scalp. It is a complication of frontal sinusitis or trauma. We present the case of an 8-year-old girl with frontal swelling. Imaging evaluation showed frontal osteomyelitis as a complication of frontal sinusitis with associated epidural and subperiosteal abscess. The patient was treated surgically and recovered well. This case highlights the need for high clinical suspicion and early diagnosis and management to prevent life-threatening complications. Unfortunately, in our case the patient had to undergo surgery for this complication, which could have been prevented by earlier diagnosis.
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Affiliation(s)
- Pranav Sharma
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta)
| | - Salil Sharma
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta)
| | - Nishant Gupta
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta)
| | - Puneet Kochar
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta)
| | - Yogesh Kumar
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta)
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Cefalea y edema fronto-orbitario de aparición súbita en un adolescente. Enferm Infecc Microbiol Clin 2017; 35:386-387. [DOI: 10.1016/j.eimc.2015.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/08/2015] [Accepted: 07/22/2015] [Indexed: 11/18/2022]
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21
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Moreno LÁ, Montoya RD, Acero de la Parra GM, Marrugo G. Pseudotumor inflamatorio de Pott: una complicación olvidada y peligrosa de la sinusitis. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n2.57974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El pseudotumor inflamatorio de Pott es una de las posibles complicaciones de la sinusitis. En la literatura existen pocos casos reportados de esta entidad, pero el presente artículo expone cuatro casos con el propósito de concientizar al grupo médico sobre la existencia de esta enfermedad y cómo su manejo temprano puede prevenir complicaciones severas.
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Costa L, Mendes Leal L, Vales F, Santos M. Pott's puffy tumor: rare complication of sinusitis. Braz J Otorhinolaryngol 2016; 86:812-814. [PMID: 27593895 PMCID: PMC9422602 DOI: 10.1016/j.bjorl.2016.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 07/06/2016] [Accepted: 08/07/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Liliana Costa
- Centro Hospitalar São João - EPE, Departamento de Otorrinolaringologia, Porto, Portugal.
| | | | - Fernando Vales
- Centro Hospitalar São João - EPE, Departamento de Otorrinolaringologia, Porto, Portugal
| | - Margarida Santos
- Centro Hospitalar São João - EPE, Departamento de Otorrinolaringologia, Porto, Portugal
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AlMoosa ZA, AlFawaz T, AlFawaz F. Pott's puffy tumor due to Aspergillus fumigatus: A case report and review. INTERNATIONAL JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE 2016; 3:128-131. [PMID: 30805483 PMCID: PMC6372439 DOI: 10.1016/j.ijpam.2016.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 06/28/2016] [Accepted: 08/01/2016] [Indexed: 11/17/2022] Open
Abstract
Pott's puffy tumor (PPT) is a very rare, nearly forgotten condition. We describe a 9-year-old girl with PPT due to trauma and surgical cultures that revealed Aspergillus fumigatus.
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Affiliation(s)
- Zainab Abdulaziz AlMoosa
- Pediatric Infectious Diseases, King Abdualziz Hospital, Ministry of National Guard, Al-Hassa, Saudi Arabia
- Corresponding author. Zainab Abdulaziz Almoosa, King Abdulaziz Hospital, Ministry of National Guard, Al-Hassa, Saudi Arabia Tel.: +966 504980068.
| | - Tariq AlFawaz
- Pediatric Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia
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van der Poel NA, Hansen FS, Georgalas C, Fokkens WJ. Minimally invasive treatment of patients with Pott's puffy tumour with or without endocranial extension - a case series of six patients: Our Experience. Clin Otolaryngol 2016; 41:596-601. [PMID: 26382235 DOI: 10.1111/coa.12538] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- N A van der Poel
- Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands.
| | - F S Hansen
- Otorhinolaryngology, Central Military Hospital, Amsterdam, Netherlands
| | - C Georgalas
- Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands
| | - W J Fokkens
- Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands
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Fullerton L, Huckerby L, Gandhi M, Jabeen F, Maity S. Trauma-related Pott's puffy tumour. Arch Dis Child 2016; 101:184. [PMID: 26489803 DOI: 10.1136/archdischild-2015-309172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Lucy Fullerton
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Lauren Huckerby
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Minal Gandhi
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Farrah Jabeen
- Department of Radiology, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Santanu Maity
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
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Stark P, Ghumman R, Thomas A, Sawyer SM. Forehead swelling in a teenage boy. J Paediatr Child Health 2015; 51:731-3. [PMID: 25418287 DOI: 10.1111/jpc.12790] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Patrick Stark
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Raymun Ghumman
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Alexandra Thomas
- Department of Otolaryngology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Liu A, Powers AK, Whigham AS, Whitlow CT, Shetty AK. A Child With Fever and Swelling of the Forehead. Pott's puffy tumor and epidural abscess complicating frontal sinusitis. Clin Pediatr (Phila) 2015; 54:803-5. [PMID: 25926666 DOI: 10.1177/0009922815584945] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ann Liu
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Amy S Whigham
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Neurosurgical implications of Pott's puffy tumor in children and adolescents. Childs Nerv Syst 2014; 30:1527-34. [PMID: 24996535 DOI: 10.1007/s00381-014-2480-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Pott's puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis. PPT is potentially severe and can lead to life-threatening intracranial complications. PATIENTS AND METHODS The authors present a series of six pediatric patients diagnosed with PPT and intracranial complications between 1999 and 2012. There were five boys and one girl, and the mean age at diagnosis was 11.8 years. All patients presented with frontal swelling, headache, and fever. Two patients had lowered level of consciousness and severe hemodynamic instability. RESULTS All patients had epidural abscess, and one also presented subdural empyema. Five patients underwent drainage of all associated abscesses, bone resection, and sinusitis treatment. One was treated conservatively with broad-spectrum antibiotics, and no surgical intervention was required. All patients fully recovered their neurologic status, without further complications.
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Leo G, Triulzi F, Incorvaia C. Sinus imaging for diagnosis of chronic rhinosinusitis in children. Curr Allergy Asthma Rep 2013; 12:136-43. [PMID: 22297923 DOI: 10.1007/s11882-012-0244-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chronic rhinosinusitis (CRS) is a relatively common disease in children but is often overlooked because at times the clinical symptoms are subtle and nonspecific. This makes imaging very important in the diagnosis. Among the different techniques, plain radiography has limited utility,whereas CT scan and MRI have a major role in evaluating the modifications caused by the disease. In particular, a CT scan provides higher resolution of bone and soft tissue and removes the overlapping structures that are present in conventional radiography. CT is recommended in isolated sphenoid sinusitis, is essential in diagnosing fungal sinusitis, and is the technique of choice when orbital complications are suspected. MRI allows investigation of not only the morphology of structures, but their intrinsic biophysical and biochemical properties, such as water content, cellular density, lipid or blood product deposits, and fibrosis. MRI allows better soft tissue differentiation and high spatial resolution images depicting fine details. When indicated, MRI with contrast gadolinium-based agents may better characterize the local disease extension or its diffusion beyond paranasal and nasal cavities and has excellent contrast resolution. A combination of CT and MRI is useful in cases of diagnostic difficulties,especially when complications are involved.
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Affiliation(s)
- Gualtiero Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Buzzi Children’s Hospital, Istituti Clinici di Perfezionamento,Via Castelvetro 32,20154 Milan, Italy.
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Kim NE, Kim SS. A Case of Pott's Puffy Tumor from Recurrent Upper Eyelid Abscess. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.5.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Nam Eok Kim
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Sang Soo Kim
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
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Akiyama K, Karaki M, Mori N. Evaluation of adult pott's puffy tumor: Our five cases and 27 literature cases. Laryngoscope 2012; 122:2382-8. [DOI: 10.1002/lary.23490] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/03/2012] [Accepted: 05/14/2012] [Indexed: 11/08/2022]
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Nisa L, Landis BN, Giger R. Orbital Involvement in Pott's Puffy Tumor: A Systematic Review of Published Cases. Am J Rhinol Allergy 2012; 26:e63-e70. [DOI: 10.2500/ajra.2012.26.3746] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
BackgroundPott's puffy tumor (PPT) is a frontal subperiosteal abscess associated with underlying frontal bone osteomyelitis. It represents a well-known source of sinogenic intracranial infection, but the orbital complications related to this entity are rarely reported. The goal of this study was to characterize the orbital involvement in PPT.MethodsWe performed a systematic review through a Medline search (1950–2010). The authors reviewed all cases of PPT, selecting those explicitly describing orbital complications associated with PPT.ResultsWe screened 139 articles, of which 93 reported cases of PPT. Of these, 35 articles described a total of 42 cases presenting simultaneous orbital complications. Eyelid and/or periorbital edema was the most common finding in patients with orbital involvement, and preseptal cellulitis is by far the most prevalent orbital complication in PPT. Postseptal involvement (orbital cellulitis, subperiosteal abscess of the orbit, and orbital abscess) is much rarer. Although treatment of the classic PPT is surgical, only a minority of patients with orbital infection required orbital drainage. Most reported patients made a full recovery, without permanent sequelae.ConclusionOrbital infections are possible in patients with PPT. In contrast to surgical treatment of the frontal subperiosteal abscess, the orbital complications can be treated conservatively most of the time. Early diagnosis and aggressive therapy of the underling PPT are essential to avoid severe local or systemic complications.
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Affiliation(s)
- Lluís Nisa
- Department of Otorhinolaryngology–Head and Neck Surgery, Hôpital de Sion, Sion, Switzerland
| | - Basile Nicolas Landis
- Smell and Taste Outpatient Clinic, Department of Otorhinolaryngology–Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology–Head and Neck Surgery, Hôpital de Sion, Sion, Switzerland
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Affiliation(s)
- Hye-Young Kim
- Department of Pediatrics, Medical Research Institute, Pusan National University College of Medicine, Busan, Korea
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The Pott’s puffy tumor: a dangerous sign for intracranial complications. Eur Arch Otorhinolaryngol 2011; 268:1755-63. [DOI: 10.1007/s00405-011-1660-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/25/2011] [Indexed: 10/18/2022]
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Piatt JH. Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study. J Neurosurg Pediatr 2011; 7:567-74. [PMID: 21631191 DOI: 10.3171/2011.3.peds10504] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Intracranial abscess is a very infrequent complication of sinusitis among children. Case series, mostly small and focusing on surgical treatment, have appeared in the literature, but there has been no study on the epidemiology of this condition, nor has there been any large-scale study on the intensity of therapy or outcomes. METHODS Data were drawn from the Kids' Inpatient Databases for 1997, 2000, 2003, and 2006 and the National Inpatient Sample for 2001. Cases were defined by the conjunction between the diagnostic codes for intracranial abscess and those for acute or chronic sinusitis or mastoiditis. RESULTS Eight hundred forty-seven hospital admissions were captured. Over the 10 years of the study, admission rates ranged between 2.74 and 4.38 per million children per year. Boys were affected much more commonly than girls. Black children were affected out of proportion to their presence in the population. The overall incidence seemed to peak in early adolescence. Sinogenic cases had a marked seasonal pattern peaking in winter, but no seasonal variation was seen for otogenic cases. Asthma comorbidity was more prevalent among sinogenic cases. The mortality rate was 2%, and death occurred only among sinogenic cases. Moreover, sinogenic cases tended to require more intensive therapy, as measured by the number of procedures, and there was a trend toward less favorable discharge dispositions. Older patients and black patients were less likely to be discharged directly to home. At least a quarter of the cases were managed without neurosurgical intervention. White patients were treated without neurosurgery more often than others. CONCLUSIONS Analysis of administrative data sets has yielded a descriptive picture of intracranial abscess complicating sinusitis among children, but the very low incidence of this condition impedes prospective clinical research directed at practical management issues.
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Affiliation(s)
- Joseph H Piatt
- Division of Neurosurgery, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA.
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Affiliation(s)
- Eveline Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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