Odontogenic Sinusitis-Associated Pott’s Puffy Tumor: A Case Report and Literature Review

Abstract

Pott’s puffy tumor (PPT) is a nonneoplastic complication of acute frontal sinusitis characterized by subperiosteal abscess (SPOA) formation and osteomyelitis. Although various clinical conditions are associated with frontal SPOA, cases associated with odontogenic sinusitis are rare. We report a recurrent case of frontal SPOA who had a previous history of craniotomy due to head trauma. The patient was presented with headache, facial swelling and diagnosed as frontal, ethmoid, and maxillary sinusitis with frontal SPOA, which is PPT. The patient was surgically managed by endoscopic sinus surgery and external drainage of the abscess. Although the symptoms had been relieved soon after the surgery, they were recurred after 1 week. By paranasal sinus computed tomography scans, it was suspected that severe carious teeth, which were missed before surgery, induced maxillary sinusitis which spread into the frontal sinus and subperiosteal areas inducing recurrence of disease. Our experience suggests that frontal SPOA may originate from odontogenic maxillary sinusitis caused by severe dental caries, which should be actively managed, especially in patients with the risk of spread of inflammation, such as those who have discontinuity in frontal bone.

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

“…Another limitation was that osseous complications from ODS were excluded from quantitative analysis. This was due to the scarcity of ODS‐related osseous complication studies, as only 4 cases have been documented 48–51 . Interestingly, a recent retrospective series of 17 frontal osteomyelitis cases showed that about 50% had dental pathology and sinusitis ipsilateral to both the dental and frontal disease on CT.…”

“…This was due to the scarcity of ODS-related osseous complication studies, as only 4 cases have been documented. [48][49][50][51] Interestingly, a recent retrospective series of 17 frontal osteomyelitis cases showed that about 50% had dental pathology and sinusitis ipsilateral to both the dental and frontal disease on CT. While dental pathology was not confirmed by dental evaluation, it is plausible that a significant proportion of those cases were from ODS.…”

Odontogenic sinusitis, a differential diagnosis: Literature review

“…Martu et al (27) concluded that the flora of the acute OS is aerobic, while in the chronic OS, it is anaerobes (Gram negative bacilli). Roderick et al and Min and Kim (18,32) agree with them because for them there is a slight predominance of anaerobes, the species being Prevotella, Fusobacterium, and Peptococcus, which are the most commonly isolated, and among the aerobic bacteria, ÿ-hemolytic streptococcal species of the viridans group were especially prevalent. McCormick et al (33) point out that any dental procedure that penetrates through the epithelial lining of the sinus may allow the proliferation of fungal species.…”

Clinical Management and Neurosurgical Approach of Pott’s Puffy Tumor: A Case Report

“…Pott’s puffy tumor (PPT), despite its name, is a non-neoplastic disease and is a subperiosteal and intracranial infection that was named by Percivall Pott, who, in 1760, described inflammation of the dura mater and skull with the formation of a mass in patients who have suffered brain trauma. Additionally, the “puffy” term in PPT refers to the soft appearance of the matter under the frontal skin [ 1 , 2 ].…”