A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving

Patel, Ami B.; Vuppula, Sharon; Hayward, Harrison; Lakhani, Anisa; Lighter, Jennifer

doi:10.1097/pec.0000000000001657

Cited by 6 publications

(4 citation statements)

References 14 publications

(6 reference statements)

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“…Squeeze occurs during descent, which causes an increase in atmospheric pressure. Typically, the sinus ostia should be open to the nasal 30 1 13 1 1 Misirovs and Mohamad 14 1 27 1 1 Sung et al 18 1 30 1 1 Boston et al 25 9 34 8 1 9 Lachkar et al (2016) 31 1 26 1 Nagatani (2013) 32 1 26 1 1 Sanborn et al (2013) 33 1 81 1 1 Jeong et al 23 1 39 1 20 1 1 Mahabir et al 20 1 68 1 1 Segev et al 24 1 43 1 1 Parell and Becker (2000) 40 2 37.5 2 O'Reilly et al (1996) 42 39 n/a n/a n/a 39 Singletary and Reilly 16 1 25 1 1 Rodenberg 13 1 Skevas et al (2012) 28 Andrews et al (2010) 34 1…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Management of Barosinusitis: A Systematic Review

Chen

Pathak²,

Hong

et al. 2022

Ann Otol Rhinol Laryngol

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Objective: To perform a systematic review to investigate the common presenting symptoms of barosinusitis, the incidence of those findings, the methods for diagnosis, as well as the medical and surgical treatment options. Methods: A review of PubMed/MEDLINE, EMBASE, and Cochrane Library for articles published between 1967 and 2020 was conducted with the following search term: aerosinusitis OR “sinus squeeze” OR barosinusitis OR (barotrauma AND sinusitis) OR (barotrauma AND rhinosinusitis). Twenty-seven articles encompassing 232 patients met inclusion criteria and were queried for demographics, etiology, presentation, and medical and surgical treatments. Results: Mean age of patients was 33.3 years, where 21.7% were females and 78.3% were males. Causes of barotrauma include diving (57.3%), airplane descent (26.7%), and general anesthesia (0.4%). The most common presentations were frontal pain (44.0%), epistaxis (25.4%), and maxillary pain (10.3%). Most patients received topical steroids (44.0%), oral steroids (28.4%), decongestants (20.7%), and antibiotics (15.5%). For surgical treatment, most patients received functional endoscopic sinus surgery (FESS) (49.6%). Adjunctive surgeries include middle meatal or maxillary antrostomy (20.7%), septoplasty (15.5%), and turbinate surgery (9.1%). The most efficacious medical treatments are as follows: 63.6% success rate with oral steroids (66 treated), 50.0% success rate with topical steroids (102 treated), and 50.0% success rate analgesics (10 treated). For surgical treatments received by greater than 10% of the sample, the most efficacious was FESS (91.5% success rate, 108 treated). Conclusion: Oral and topical steroids should be first line therapies. If refractory, then functional endoscopic sinus surgery is an effective treatment.

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Section: Discussionmentioning

confidence: 99%

“…Bourolias and Gkotsis (2011) 36 Özturk and Bozkurt (2020) 27 Patel et al (2021) 30 Misirovs and Mohamad 14 Sung et al 18 Boston et al 25 Lachkar et al (2016) 31 1 1 Nagatani (2013) 32 1…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Barosinusitis: A Systematic Review

Chen

Pathak²,

Hong

et al. 2022

Ann Otol Rhinol Laryngol

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“…9 PTT is commonly related as a complication of a frontal or ethmoidal sinusitis, acute or chronic, but can see cases related after front bone trauma 11,12,29 , and even barotrauma can be associated. 13 PPT is a disease with low incidence and with few cases reported; this can be explained nowadays due to the widespread use of antibiotics. 29 The prevalence of PTT is higher among teenagers, because the venous drainage by diploic veins flow is increased during this stage of life, and can spread the infection easier, 4 other possible causes of this epidemiology is an anatomical characteristic, like late complete aeration of the frontal sinus 3,8,13,14 , which are often pneumatized by 2 years of age and are approximate adult size by the late teens.…”

Section: Discussionmentioning

confidence: 99%

“…13 PPT is a disease with low incidence and with few cases reported; this can be explained nowadays due to the widespread use of antibiotics. 29 The prevalence of PTT is higher among teenagers, because the venous drainage by diploic veins flow is increased during this stage of life, and can spread the infection easier, 4 other possible causes of this epidemiology is an anatomical characteristic, like late complete aeration of the frontal sinus 3,8,13,14 , which are often pneumatized by 2 years of age and are approximate adult size by the late teens. 3 But adults can be affected by the PTT, although rare, according to the world English-language literature, only 30-40 cases of adult patients with PPT were reported between 1990 and 2016.…”

Section: Discussionmentioning

confidence: 99%

Pott’s Puffy Tumor - Overview of case series

Severo

Medeiros²,

Gadelha³

et al. 2021

jmm

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Pott’s puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis that has been neglected or partially treated, resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis, which can lead to life-threatening intracranial complications, such as epidural/subdural empyema, cerebral abscess and meningitis. Given this, the purpose of the present study was to gather the most diverse cases reported together to highlight the main treatment methods. Methods: It is a narrative review, starting from the search in the database PubMed, Lilacs and Scielo from 2010 to 2020, which resulted in 34 scientific articles. The search focused on obtaining data on new approaches and treatments established for Pott’s puffy tumor. Results: 34 articles were included which described 58 patients with a swollen Pott tumor, occurring predominantly in male adolescents, with streptococci (26,1%) as the main etiologic agent. Approximately 84% of all patients were male subjects. The most prevalent intracranial complication was an epidural or extradural abscess (84,2%). Regarding PTT therapy, all patients received antibiotic therapy (ATB), and the main empirical antimicrobial scheme used was cephalosporin third generation, with vancomycin and metronidazole. In most cases, surgery was performed using several techniques, mainly an external surgical approach, external drainage (ED) of the subperiosteal abscess associated with endoscopic sinus surgery (ESS). In general, the prognosis is favorable, even if neurological symptoms are present at admission. Conclusion: Based on available literature, PPT is a profoundly serious complication, which can be easily avoided if treated with the ATB, ED and ESS triad immediately, and, if necessary, craniotomy.

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Pott’s puffy abscess: Moniker change from historical misnomer of Pott’s puffy tumor

Jho

Young

et al. 2020

Interdisciplinary Neurosurgery

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A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving

Cited by 6 publications

References 14 publications

Diagnosis and Management of Barosinusitis: A Systematic Review

Diagnosis and Management of Barosinusitis: A Systematic Review

Pott’s Puffy Tumor - Overview of case series

Pott’s puffy abscess: Moniker change from historical misnomer of Pott’s puffy tumor

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