First described in 1768, the Pott's puffy tumor is a subperiosteal abscess associated with frontal bone osteomyelitis, resulting from trauma or frontal sinusitis. The classic clinical presentation consists of purulent rhinorrhea, fever, headache, and frontal swelling. The diagnosis is confirmed by CT scan and treatment requires intravenous antibiotics, analgesia, and surgical intervention. Early diagnosis and aggressive medical and surgical approach are essential for a good outcome. It rare and the early diagnosis is important; we describe the case of a 14-year-old adolescent with Pott's puffy tumor who was initially treated inadequately, evolving with extensive frontoparietal abscess. The patient underwent surgical treatment with endoscopic endonasal and external approaches combined. Intravenous antibiotics were prescribed for a prolonged time, with good outcome and remission of the complaints.

Introduction: Cochlear implantation (CI) is a worldwide procedure that provides hearing rehabilitation and improves speech perception. One of the described complications is the device migration, which can result of failure of receiver-stimulator (R/S) fixation. This study aims to describe the outcomes of cochlear implant receiver-stimulator (RS) placement (bone well and the subperiosteral temporal pocket technique without fixation). Methods: A retrospective case review is developed in tertiary care university hospital center that compares the bone well and the subperiosteral temporal pocket technique without fixation in two periods (at the end of the surgery and one year after CI surgery). Results: The age range from 22 to 64 years (average of 41.2 year-old). Follow-up time ranges from 12 to 51 months (average 24 months). The patients, divided into two groups (subperiostal pocket = 6 patients and bone well = 3 patients), are analyzed through major and minor complications. No intraoperative wounds or intracranial complications have been observed in either group. Device migration occurs in three patients of subperiostal pocket group (50%), but with no apparent clinical outcomes. The migration measure is about not more than 1 up to 2 centimeters antero-inferiorly by the radiography evaluation. Conclusion: Device migration is more frequent in the subperioteal pocket group (50%) with statistical significance (p < 0.05). However it is not identified, apparently, no clinical and aesthetic account related to this situation.

The present study demonstrates practical and useful tools for evaluating cochlear implant electrodes in clinical practice. Further studies should measure preoperative and postoperative benefits in terms of speech recognition and evaluate the preservation of residual hearing in the implanted ear. Such studies can also determine correlations between surgical factors, electrode positions, and performance. In addition to refined surgical techniques, the precise evaluation of cochlear length and correct choice of cochlear implant characteristics can play an important role in postoperative outcomes.

No abstract