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

Abstract

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.

Draf III frontal sinus surgery for the treatment of Pott’s puffy tumour in adults: our case series and a review of frontal sinus anatomy risk factors

“…In a recent review of the literature which included 83 paediatric and adolescent patients surgically treated for PPT, Koltsidopoulos et al, reported that an external approach was used in most of the cases (46.5%), while an endoscopic treatment was used alone in 20% of cases and in combination with an external drainage in 27% of cases. In the remaining cases (3.5%), no surgical treatment was adopted [24]. In another review of the literature published in 2012 including 32 adult patients with PPT after 1990, Akiyama and colleagues reported that external surgical procedure was chosen in 58.1% of the cases, but ESS in combination with an external subperiosteal abscess drainage was adopted in 32.9% of the rest.…”

Non-Traumatic Pneumocephalus and Sub-Dural Empyema as a Complication of Chronic Sinusitis

“…Acute sinusitis lasts less than 12 weeks and it is usually caused by rhinoviruses, parainfluenza and influenza virus. Chronic sinusitis lasts more than 12 weeks and it is usually caused by anaerobes, gram-negative bacteria, Staphylococcus aureus , and fungi [4].…”

Imaging of Paranasal Sinus Infections in Children: A Review

“…PPT is classically associated with osteomyelitis of the frontal bone secondary to frontal BARS or trauma 80 . Localized frontal swelling is the most common clinical finding and PPT frequently develops after a misdiagnosed or inadequately treated frontal BARS 81 . The diagnosis of PPT is based on history and clinical and imaging findings (Fig 12).…”

“…The diagnosis of PPT is based on history and clinical and imaging findings (Fig 12). CT is the imaging modality of choice to confirm the diagnosis 81 . The prevalence of PPT has decreased in the postantibiotic era, however, it may cause potentially devastating complications including preseptal and orbital cellulitis.…”