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Palmer A, Mas-Castells M, Scawn R. A case of Pott's puffy tumor presenting as orbital cellulitis. J Fr Ophtalmol 2024; 47:104243. [PMID: 38996594 DOI: 10.1016/j.jfo.2024.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/21/2024] [Accepted: 05/15/2024] [Indexed: 07/14/2024]
Affiliation(s)
- A Palmer
- Imperial College School of Medicine, Imperial College London, Exhibition Road, SW7 2AZ, London, United Kingdom.
| | - M Mas-Castells
- Chelsea and Westminster NHS Trust, 369, Fulham Road, SW10 9NH, London, United Kingdom
| | - R Scawn
- Chelsea and Westminster NHS Trust, 369, Fulham Road, SW10 9NH, London, United Kingdom
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2
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Pimiento Figueroa J, Mejia M, Bohorquez D. Pott's Puffy Tumor: A Case Report on Diagnosis Through Imaging. Cureus 2024; 16:e58640. [PMID: 38770497 PMCID: PMC11104277 DOI: 10.7759/cureus.58640] [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: 04/20/2024] [Indexed: 05/22/2024] Open
Abstract
Pott's puffy tumor (PPT) is a rare but life-threatening complication of chronic sinusitis, although it can be secondary to other entities such as trauma or insect bites. It is characterized by circumscribed frontal swelling associated with a subperiosteal abscess. Imaging plays a crucial role in diagnosis and early identification of complications, some of which can be life-threatening, including intracerebral and intra-orbital complications. We present a case of a 14-year-old male with non-specific frontal pain and swelling, where the diagnosis of PTT was confirmed through imaging studies. Upon admission, the patient exhibited orbital and intracerebral complications, as shown in MRI and CT scans. Treatment involved a combination of antibiotics and sinus surgery, with close monitoring for orbital and intracranial complications.
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Affiliation(s)
| | - Marcia Mejia
- Radiology, Universidad de Antioquia, Medellín, COL
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3
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邓 慧, 陈 志, 吴 喜, 杨 钦. [Characteristics and therapeutic strategies of Pott's puffy tumor]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2024; 38:83-85;90. [PMID: 38297856 PMCID: PMC11116150 DOI: 10.13201/j.issn.2096-7993.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/15/2023] [Indexed: 02/02/2024]
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.
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Affiliation(s)
- 慧仪 邓
- 中山大学附属第三医院耳鼻咽喉-头颈外科变态反应(过敏)科(广州,510630)Department of Otolaryngology-Head and Neck Surgery, Department of Allergy, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - 志鹏 陈
- 深圳市龙岗区第二人民医院眼耳鼻喉科Department of Ophthalmology and Otorhinolaryngology, the Second People′s Hospital of Longgang District
| | - 喜福 吴
- 中山大学附属第三医院耳鼻咽喉-头颈外科变态反应(过敏)科(广州,510630)Department of Otolaryngology-Head and Neck Surgery, Department of Allergy, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - 钦泰 杨
- 中山大学附属第三医院耳鼻咽喉-头颈外科变态反应(过敏)科(广州,510630)Department of Otolaryngology-Head and Neck Surgery, Department of Allergy, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
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4
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Al Doaibel K, Hasan F, Antar H, Hasan Z, Alfeki S. Frontal Headache and Swelling: A Case Report of Pott's Puffy Tumor. Cureus 2023; 15:e50670. [PMID: 38229811 PMCID: PMC10790809 DOI: 10.7759/cureus.50670] [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: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
Pott's puffy tumor, a rare complication of frontal sinusitis, poses a diagnostic challenge due to its infrequency and diverse clinical manifestations. Recognizing this condition promptly is crucial due to the potential for severe neurological compromise. We present the case of a 32-year-old male who presented with a one-week history of frontal headache, tenderness, and swelling following an upper respiratory tract infection. The physical examination revealed a tense, erythematous swelling over the frontal region. Laboratory results showed elevated inflammatory markers. Computed tomography revealed an epidural abscess secondary to frontal sinusitis. An emergent craniotomy was performed to evacuate the collection, followed by intravenous antibiotic therapy. The patient recovered with no neurological deficits. This case emphasizes the importance of considering Pott's puffy tumor in patients with frontal swelling and associated symptoms. Despite its rarity, a multidisciplinary approach involving imaging, microbiological analysis, and surgical intervention enables an accurate diagnosis and successful management. Timely recognition and appropriate treatment, including surgical drainage and targeted antibiotics, are critical for achieving favorable outcomes.
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Affiliation(s)
| | - Fatema Hasan
- General Practice, Xi'an Jiaotong University, Xi'an, CHN
| | - Hawra Antar
- General Practice, Wenzhou Medical University, Wenzhou, CHN
| | - Zahra Hasan
- General Practice, National University of Science and Technology, Muscat, OMN
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5
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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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6
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Russ A, Morse A, Spiro D. When a Headache Is More than the Flu: A Case Report. Clin Pract Cases Emerg Med 2022; 6:240-243. [PMID: 36049203 PMCID: PMC9436497 DOI: 10.5811/cpcem2022.6.56491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction When influenza (flu) season arrives, it is easy for emergency department clinicians to anchor on the diagnosis of flu, sending patients on their way with or without anti-influenza medication. It is important not to miss the outlier – the patient who seems to have typical symptoms of influenza but with certain subtleties that should make one consider expanding the differential diagnosis. Case Report We describe an 11-year-old previously healthy male who presented with eight days of fever, myalgias, cough, congestion, and headache in the context of positive influenza exposure. The length and severity of his symptoms prompted laboratory and imaging investigation. He was positive for influenza type B with elevated inflammatory markers but otherwise normal laboratory workup and normal chest radiograph. He complained of a headache and was given fluids and antipyretics, and was admitted for overnight observation. He specifically did not have any forehead swelling. The next day during his inpatient stay he developed right frontal forehead edema and appeared ill. He was taken for a sinus computed tomography, which showed changes consistent with frontal bone osteomyelitis. Even after drainage by neurosurgery and otolaryngology, the patient subsequently developed repeat abscesses and ultimately a superior sagittal sinus thrombosis. Conclusion Other sources of infection should be considered in patients who have flu-like symptoms that last longer than expected, present with focality, or appear ill.
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Affiliation(s)
- Abigail Russ
- University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas
| | - Amber Morse
- University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas
| | - David Spiro
- University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas
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7
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Silva ACV, Lins CM, Mendes RFDA, Silva MHS, de Alencar Neto JF, Lopes C, Ferraz GLDS, de Sousa D, Bem Junior LS, Valença MM, de Azevedo-Filho HRC. Case Report: Pott's Edematous Tumor: Complicated Frontal Sinusitis - An Unremembered Diagnosis. Front Surg 2022; 9:889463. [PMID: 35832496 PMCID: PMC9271968 DOI: 10.3389/fsurg.2022.889463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Pott’s Puffy tumor, also called Pott’s edematous tumor (PET), is a subperiosteal abscess of the frontal bone, associated with osteomyelitis of the frontal bone. In this paper, we report the case of a 16-year-old patient who presented with headache associated with progressive forehead swelling and fever. Clinical and imaging exams pointed to the hypothesis of PET associated with brain abscess. Patient was submitted to surgical excision of the abscess and treatment of osteomyelitis, with intraoperative findings corroborating the condition. There was a good clinical-radiological recovery associated with prolonged antibiotic therapy and satisfactory follow-up after hospital. PET, which often results from an underdiagnosed or partially treated frontal sinusitis, is a condition that must be promptly recognized and directed to an adequate therapeutic approach due to the risk of serious complications that it entails.
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Affiliation(s)
- Ana Cristina Veiga Silva
- Department of Neurosurgery, Hospital da Restauração, Recife, Brazil
- Neuroscience Post-Graduate Program, Federal University of Pernambuco, Recife-PE, Brazil
- Correspondence: Ana Cristina Veiga Silva
| | | | | | | | | | | | | | | | | | | | - Hildo Rocha Cirne de Azevedo-Filho
- Department of Neurosurgery, Hospital da Restauração, Recife, Brazil
- Neuroscience Post-Graduate Program, Federal University of Pernambuco, Recife-PE, Brazil
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8
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Hitt N, Rosengren T, Delaney T, Dettmer T. Pott’s Puffy Tumor in an Adult Female: A Case Report in a Rare Demographic. Cureus 2022; 14:e24922. [PMID: 35698718 PMCID: PMC9187141 DOI: 10.7759/cureus.24922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/05/2022] Open
Abstract
Pott’s puffy tumor (PPT) is a localized forehead swelling with underlying subperiosteal abscess formation and osteomyelitis of the frontal bone. It is a rare complication of frontal sinusitis, and it is especially rare in adult females. A careful review of existing literature identified only 17 cases in adult females. Treatment requires antibiotic therapy and often surgical drainage/debridement. Here, we present a case of a 76-year-old female diagnosed with PPT. She was placed on amoxicillin-clavulanate 875 mg twice daily for six weeks. Her symptoms resolved with the antibiotic course, and she is scheduled for otolaryngology (ENT) follow-up, including dedicated sinus computed tomography (CT). While Pott’s puffy tumor is a rare manifestation of chronic sinusitis, it is important to recognize and treat to avoid serious intracranial complications.
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9
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Faridi MMA, Pandey S, Shamsi S. Pott's Puffy Tumor Presenting as Pyogenic Meningitis in an Infant. Case Rep Pediatr 2022; 2022:4732287. [PMID: 35371577 PMCID: PMC8975695 DOI: 10.1155/2022/4732287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/10/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction. Pott's puffy tumor is characterized by the osteomyelitis of the frontal bone with underlying subperiosteal abscess, mostly occurring secondary to recurrent sinusitis or head trauma. Though it is a rare clinical entity in this antibiotic era, its occurrence mostly in the adolescent age group has now shown increased reporting lately in all age groups. Case Description. We describe here a case of a 4½-month-old female baby who presented to our hospital's Emergency Room with clinical features of pyogenic meningitis following aspiration of a midline frontal swelling. The infant presented with high-grade fever, 3-4 episodes of projectile vomiting, increased irritability, and refusal to breastfeeding than usual. This was accompanied by a history of a gradually increasing midline fluctuant erythematous swelling on her forehead extending to the left eye. Aspiration of the swelling was done a day before by a local general practitioner, following which she developed the above-mentioned features of pyogenic meningitis and was brought to the hospital the next day. Examination revealed a conscious, febrile, irritable child with bulging anterior fontanel and 101.4°F axillary temperature. Vital signs were within normal limits. CSF analysis was suggestive of pyogenic meningitis, and appropriate antibiotics were given. MRI showed frontal bone osteomyelitis with erosion of the bony plate and focal cerebritis. The condition turned out to be Pott's puffy tumor with pyogenic meningitis after detailed investigations. The infant was treated with appropriate antibiotics and other supportive therapeutic measures and discharged with the advice for further management in collaboration with otorhinolaryngologist.
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Affiliation(s)
- M. M. A. Faridi
- 1Faculty of Medicine, Department of Pediatrics, Era's Lucknow Medical College & Hospital, Lucknow-226003, India
| | - Somya Pandey
- 2Department of Pediatrics, Era's Lucknow Medical College & Hospital, Lucknow-226003, India
| | - Sumaiya Shamsi
- 2Department of Pediatrics, Era's Lucknow Medical College & Hospital, Lucknow-226003, India
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10
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Pediatric Headache Attributed to Infection. Semin Pediatr Neurol 2021; 40:100923. [PMID: 34749918 DOI: 10.1016/j.spen.2021.100923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022]
Abstract
Pediatric headaches attributed to infection are typically related to non-life threatening illnesses such as upper respiratory tract infections and rhinosinusitis. Although less common, secondary headaches related to life threatening infections are most frequently associated with meningitis. This review provides an overview of the International Classification of Headache Disorders third edition (ICHD-3) categories of infections contributing to secondary headache, describes clinical presentation, and presents a focused review on relevant diagnoses associated with this headache type. An understanding of headache attributed to infection will provide the foundation on distinguishing secondary headaches from various etiological infectious disorders.
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11
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Thompson HM, Tilak AM, Miller PL, Grayson JW, Cho DY, Woodworth BA. Treatment of Frontal Sinus Osteomyelitis in the Age of Endoscopy. Am J Rhinol Allergy 2020; 35:368-374. [PMID: 32938198 DOI: 10.1177/1945892420959587] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Frontal sinus osteomyelitis is a severe complication which can result from chronic rhinosinusitis, trauma, or as a complication of reconstruction or obliteration of the frontal sinus. The objective of the current study is to evaluate the contemporary management of frontal sinus osteomyelitis in light of recent advancements in endoscopic surgical techniques. METHODS Review of a prospectively collected database of patients with frontal sinus pathology was performed from 2008-2020. Data from individuals with frontal sinus osteomyelitis was collected including demographics, etiology, surgical technique, adjunctive medical treatments, complications, and clinical follow up. RESULTS Sixteen patients (average age 48.3, range 8-84) were included in the study. An open approach was utilized in 6 patients (2 osteoplastic flaps, 3 Reidel procedures, 1 cranialization). Seven patients underwent completely endoscopic approaches (3 Draf IIB, 4 Draf III), while 3 individuals had combined procedures (Lynch with Draf III, osteoplastic flap + Draf III, fistula excision + Draf IIb). All patients received 6 weeks of antibiotics. Average clinical follow up was 24.4 months with no patients requiring revision procedures. CONCLUSION Endoscopic, endoscopic-assisted, and open approaches were utilized successfully in the current series of patients with osteomyelitis of the anterior table of the frontal sinus. While the progression of endoscopic techniques allows an additional surgical treatment option, it is important to select patients appropriately as open procedures continue to have an important role in the treatment algorithm.
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Affiliation(s)
- Harrison M Thompson
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Ashwini M Tilak
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Peter L Miller
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Jessica W Grayson
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Do-Yeon Cho
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Bradford A Woodworth
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
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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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Weiss CR, Bailey CR, Hohenwalter EJ, Pinchot JW, Ahmed O, Braun AR, Cash BD, Gupta S, Kim CY, Knavel Koepsel EM, Scheidt MJ, Schramm K, Sella DM, Lorenz JM. ACR Appropriateness Criteria® Radiologic Management of Infected Fluid Collections. J Am Coll Radiol 2020; 17:S265-S280. [PMID: 32370971 DOI: 10.1016/j.jacr.2020.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 11/20/2022]
Abstract
Infected fluid collections are common and occur in a variety of clinical scenarios throughout the body. Minimally invasive image-guided management strategies for infected fluid collections are often preferred over more invasive options, given their low rate of complications and high rates of success. However, specific clinical scenarios, anatomic considerations, and prior or ongoing treatments must be considered when determining the optimal management strategy. As such, several common scenarios relating to infected fluid collections were developed using evidence-based guidelines for management. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Eric J Hohenwalter
- Panel Chair, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jason W Pinchot
- Panel Vice-Chair, University of Wisconsin, Madison, Wisconsin
| | | | - Aaron R Braun
- St. Elizabeth Regional Medical Center, Lincoln, Nebraska
| | - Brooks D Cash
- University of Texas Health Science Center at Houston and McGovern Medical School, Houston, Texas; American Gastroenterological Association
| | - Samir Gupta
- Rush University Medical Center, Chicago, Illinois; American College of Surgeons
| | - Charles Y Kim
- Duke University Medical Center, Durham, North Carolina
| | | | | | - Kristofer Schramm
- University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado
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14
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[Pott's puffy tumour: innovative technique in calvarial reconstruction]. The Journal of Laryngology & Otology 2019; 133:1005-1008. [PMID: 31587674 DOI: 10.1017/s0022215119002093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pott's puffy tumour is a rare complication of sinusitis. This osteomyelitis can affect the outer and inner tables of the frontal sinus. The treatment of Pott's puffy tumour combines medical and surgical approaches. Surgical approaches have traditionally been open, but endoscopic techniques have been adopted recently in select cases. The bony defect from debridement can be left alone, or closed with autografts or allografts. OBJECTIVE To describe a technique for the reconstruction of a large skull vault after the debridement of extensive osteomyelitis of the anterior cranial vault. METHODS Modified distraction osteogenesis is used in the cranial vault, to induce new bone formation. This is customarily used to lengthen long bones. The advantages of this technique include avoiding autologous grafts or alloplastic cranioplasty in the infected surgical bed, and allowing primary closure. RESULTS Early post-operative imaging results have been encouraging, with no reported complications. CONCLUSION Modified distraction osteogenesis is a novel technique in the primary reconstruction of calvarial bone.
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15
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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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16
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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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17
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Mangla R, Mangla M, Li S, Abdelbaki A, Bansal I, Kumar A, Kumar Y. Dedifferentiated parosteal osteosarcoma of the calvaria. Proc AMIA Symp 2018; 31:76-78. [PMID: 29686561 DOI: 10.1080/08998280.2017.1391047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Dedifferentiated parosteal osteosarcoma is a rare tumor and is even rarer when involving the skull bones. We present a case of a 57-year-old man with a partially ossified progressive enlarging left skull mass in the left temporoparietal region, with erosion of the outer table. Radiological diagnosis of dedifferentiated parosteal osteosarcoma was suggested, and histopathology confirmed the diagnosis.
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Affiliation(s)
- Rajiv Mangla
- Department of Radiology, State University of New York Upstate Medical University, Syracuse, New York
| | - Manisha Mangla
- Department of Radiology, State University of New York Upstate Medical University, Syracuse, New York
| | - Shuo Li
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut
| | - Ahmed Abdelbaki
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut
| | - Itisha Bansal
- Department of Anesthesia, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York
| | - Anil Kumar
- Department of Neurology, Great Plains Health, North Platte, Nebraska
| | - Yogesh Kumar
- Department of Radiology, Bassett Medical Center at Columbia University, Cooperstown, New York
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18
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Goyal P, Lee S, Gupta N, Kumar Y, Mangla M, Hooda K, Li S, Mangla R. Orbital apex disorders: Imaging findings and management. Neuroradiol J 2018; 31:104-125. [PMID: 29415610 DOI: 10.1177/1971400917740361] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies, including trauma, neoplastic, developmental, infectious, inflammatory as well as vascular causes. In the past, these have been described separately based on anatomical locations of disease process; however, these three disorders share similar causes, diagnostic evaluation and management strategies. The etiology is diverse and management is directed to the causative process. This imaging review summarizes the pertinent anatomy of the orbital apex and illustrates representative pathological processes that may affect this region. The purpose of this review is to provide an update on the current status of diagnostic imaging and management of patients with orbital apex disorders.
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Affiliation(s)
- Pradeep Goyal
- 1 21611 St. Vincent's Medical center , Bridgeport, CT, USA
| | | | | | - Yogesh Kumar
- 4 Columbia University at Bassett Healthcare, Cooperstown, NY
| | | | - Kusum Hooda
- 6 Yale New Haven Health at 1939 Bridgeport Hospital , Bridgeport, CT, USA
| | - Shuo Li
- 6 Yale New Haven Health at 1939 Bridgeport Hospital , Bridgeport, CT, USA
| | - Rajiv Mangla
- 7 SUNY Upstate Medical University, Syracuse, NY, USA
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