Not just a bump on the head: ultrasound as first‐line imaging in a boy with Pott's puffy tumour

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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“…Most of the articles were either case series or case reports. The characteristics of the included studies are summarized in Table …”

Section: Resultsmentioning

confidence: 99%

“…Along with more established imaging modalities, ultrasound has been proposed by some authors for the detection of PPT in children . According to them, sonography could be used as a first‐line modality in cases with low clinical suspicion of PTT to rule out this condition and avoid unnecessary CT.…”

Section: Discussionmentioning

confidence: 99%

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

2018

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“…Here, liquid components such as pus in the swelling can be revealed and structures of the frontal bone can be assessed more precisely [ 16 ]. As a less invasive method, ultrasound should be favored especially for children instead of MRI and/or CT [ 18 ]. To identify the destruction of the frontal bone and subperiosteal fluid collection, contrast-enhanced CT is considered most effective [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Pott’s puffy tumor: a need for interdisciplinary diagnosis and treatment

Kühn

Linsler

Nourkami-Tutdibi

et al. 2022

HNO

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Pott’s puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics. We present a series of four cases of PPT that occurred in two children (6 and 9 years) and in two young adults (17 and 19 years). All patients were treated by an interdisciplinary team of pediatric, neurosurgical, ENT, radiological, and neuroradiological specialists. Antibiotic treatment was combined with single endoscopic surgery in one case and combined endoscopic sinus surgery with an open transcranial approach to drain intracranial abscess formation in three cases. It is important to be aware that PPT occurs in children with the finding of intracranial abscess formation. Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease.

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“…Hierbei kann zum einen zwischen einer soliden oder liquiden Schwellung unterschieden werden, und es können die Strukturen des Os frontale genauer beurteilt werden [ 16 ]. Als weniger invasive Methode sollte der Ultraschall besonders für Kinder vor der MRT- und/oder CT-Untersuchung eingesetzt werden [ 18 ]. Um jedoch in letzter Konsequenz die Destruktion des Os frontale und eine subperiostale Flüssigkeitssammlung zu diagnostizieren, wird eine kontrastmittelverstärkte CT-Untersuchung als Goldstandard angesehen [ 5 ].…”

Section: Diskussionunclassified

Pott-Puffy-Tumor: die Notwendigkeit einer interdisziplinären Diagnostik und Behandlung

Kühn

Linsler

Nourkami-Tutdibi

et al. 2022

HNO

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ZusammenfassungDer Pott-Puffy-Tumor (PPT) stellt als bakterielle Infektion des Sinus frontalis mit subperiostaler und intrakranieller Abszessbildung eine seltene Erkrankung in der Pädiatrie dar. Nachfolgend präsentieren wir vier Fälle eines PPT, die bei zwei Kindern (6 und 9 Jahre) und bei zwei jungen Erwachsenen (17 und 19 Jahre) auftraten. Alle Patienten wurden interdisziplinär von einem Team aus Neurochirurgie, Pädiatrie, HNO-Heilkunde, Neuroradiologie und Mikrobiologie betreut. Die Antibiotikabehandlung wurde in einem Fall mit einer endoskopischen Nasennebenhöhlenoperation (FESS) und in den anderen drei Fällen zusätzlich mit einem offenen transkraniellen Zugang zur Drainage der intrakraniellen Abszessbildung kombiniert. Da der PPT im Kindesalter mit dem Befund einer intrakraniellen Abszessbildung einhergehen kann, ist eine enge interdisziplinäre Zusammenarbeit für eine erfolgreiche Behandlung dieser seltenen Erkrankung erforderlich.

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Not just a bump on the head: ultrasound as first‐line imaging in a boy with Pott's puffy tumour

Cited by 6 publications

References 7 publications

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

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

Pott’s puffy tumor: a need for interdisciplinary diagnosis and treatment

Pott-Puffy-Tumor: die Notwendigkeit einer interdisziplinären Diagnostik und Behandlung

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