Pott's puffy tumor (PPT) was firstly described by Percival Pott in 1760. 1 With the increasing use of antibiotics, the frequency of this rare disease, which is mostly a complication of sinusitis, has decreased even more. The disease may rarely progress and a cutaneous fistula can be formed. 2 Although it is most common after acute sinusitis, it can also be seen after trauma, surgery, cocaine use, insect bite, mastoiditis or dental infections. 3 It can ocur due to hematogenous spread of the infection or to direct extension of infection. It is more common in adolescence due to increased diploic vein flow rate. 4 It can lead to intracranial complications by direct spread with bone erosion or through diploic veins. 4 The patient may present with cranial complications, especially in patients who are treated inappropriately and the symptoms are not severe and ignored because of this. 5
CASE REPORTA 47-year-old male patient presented to our clinic with swelling of the forehead which had first appeared one week earlier, headache and erythematous ulcerated lesion on forehead skin. Diagnostic nasal endoscopy shows thick purulent discharge in the left middle meatus.
<b><i>Introduction:</i></b> Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs. <b><i>Methods:</i></b> The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared. <b><i>Results:</i></b> The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (<i>p</i> > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (<i>p</i> > 0.05). <b><i>Conclusion:</i></b> Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable.
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