Neurosurgical implications of Pott’s puffy tumor in children and adolescents

Salomão, J. Francisco; Protzenko, Tatiana; Bellas, Antonio Rosa; Boechat, M. Ines; Pone, Sheila Moura; Pone, Marcos V.S.; Pereira, Bernardo de A.

doi:10.1007/s00381-014-2480-x

Cited by 45 publications

(69 citation statements)

References 42 publications

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“…These signs of osteomyelitis were absent in our patient’s case, and CT scan done 3 years prior to the presentation shows that frontal bone defect was present already at that time likely secondary to craniotomy and/or RTA 25 years ago (figures 7 and 8). Salomoa et al demonstrated their case series of six paediatric patients with PPT that frontal bone thickness erosions of variable size were identified in all CT head scans and intraoperatively in operated patients 5. No signs of osteomyelitis were identified intraoperatively in our patient’s case.…”

Section: Discussionsupporting

confidence: 49%

“…The infection spreads either directly through the sinus wall or by means of retrograde thrombophlebitis. The anterior wall and the floor of the frontal sinus are frequently the pathway of least resistance for the infection 5. In our patient, frontal sinus infection spread via patent roof of the frontal sinus to prefrontal soft tissue space following the pathway of least resistance and not spreading intracranially.…”

Section: Discussionmentioning

confidence: 55%

“…CT scan has become the standard tool for diagnosis and for identification of osteomyelitis of frontal bone as bone destruction and periosteal reaction 5. These signs of osteomyelitis were absent in our patient’s case, and CT scan done 3 years prior to the presentation shows that frontal bone defect was present already at that time likely secondary to craniotomy and/or RTA 25 years ago (figures 7 and 8).…”

Section: Discussionmentioning

confidence: 58%

“…Least common causes of PPT are mastoiditis, intranasal methamphetamine use, cocaine abuse, dental infection, hair transplantation, ethmoidal sinusitis, acupuncture, insect bite and infected frontal sinus mucocele 5. In our patient’s case, potentially the abscess was caused by foreign body reaction of the prosthetic studs, but it is very unlikely as the patient had had it for 25 years.…”

Section: Discussionmentioning

confidence: 69%

“…In 1879, Lannelongue demonstrated that PPT resulted from progression of frontal sinusitis to osteomyelitis with erosion through the frontal bone anteriorly, which is currently known as the main aetiological factor 5. The infection spreads either directly through the sinus wall or by means of retrograde thrombophlebitis.…”

Section: Discussionmentioning

confidence: 99%

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Not quite Pott’s puffy tumour

Misirovs¹,

Gohil

Ross

et al. 2018

BMJ Case Reports

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Pott's puffy tumour (PPT) is characterised by a subperiosteal abscess associated with osteomyelitis of the frontal bone-a rare complication of frontal sinusitis, more common in the paediatric population. We describe a case mimicking PPT, where abscess extension was facilitated by previous surgery. Usually patients with PPT would be systemically unwell, but our patient, a 63-year-old Caucasian man, was systemically well with a large swelling of his forehead. A CT was performed to evaluate possible intracranial and intracerebral complications such as epidural, subdural and brain abscesses. Emergent surgical drainage was performed with prolonged administration of antibiotic therapy. 12 weeks later, he had recollection in the frontal sinus requiring incision and drainage. 6 weeks afterwards, he underwent planned Lothrop procedure and endoscopic sinus surgery. Although clinically the patient presented with overwhelming features of PPT, we emphasise that PPT involves osteomyelitis of frontal bone, which is absent in our case.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Not quite Pott’s puffy tumour

Misirovs¹,

Gohil

Ross

et al. 2018

BMJ Case Reports

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show abstract

Epidural abscess

Lam¹,

Okechi²,

Fridley³

2016

International Neurology

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Pott's puffy tumor in children: A review of the literature

2018

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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.

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Neurosurgical implications of Pott’s puffy tumor in children and adolescents

Cited by 45 publications

References 42 publications

Not quite Pott’s puffy tumour

Not quite Pott’s puffy tumour

Epidural abscess

Pott's puffy tumor in children: A review of the literature

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