<scp>P</scp>ott's puffy tumor in a 12‐year‐old boy

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%

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

2018

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“…Clinical features include headache, swelling in the periorbital or scalp regions, fever, and nasal discharge. Fluctuant swelling in the midline of the forehead is typical [ 8 ]. CT scan is the criterion standard for diagnosis of PPT [ 6 ], and it usually shows involvement of bone and paranasal sinuses.…”

Section: Discussionmentioning

confidence: 99%

Pott’s Puffy Tumor in an Inflammatory Bowel Disease Patient on Anti-TNF Therapy

et al. 2021

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Patient: Male, 14-year-old Final Diagnosis: Pott’s puffy tumor Symptoms: Face swelling Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Infectious Diseases • Otolaryngology • Pediatrics and Neonatology Objective: Unusual clinical course Background: Anti-TNF-α therapies were the first class of biologics to be used in treatment of moderate to severe IBD. Immunosuppression status that develops from using anti-TNF-α therapies increases the risk of serious and opportunistic infections. We present here a rare case of serious infection that developed in an IBD patient while on anti-TNF therapy. Case Report: Our patient was a 14-year-old boy with a history of chronic sinusitis and ulcerative colitis who had been on infliximab therapy for the last 3 years. He presented with facial swelling and worsening constant frontal headache. Imaging showed frontal scalp subgaleal abscess, mild frontal calvarial early osteomyelitis, bilateral preseptal cellulitis, and acute and chronic paranasal sinus disease. He was treated with intravenous antibiotics and underwent sinus surgery with incision and drainage of the forehead abscess. He recovered well and resumed his infliximab infusions 3 weeks after the surgery. Conclusions: PPT is a serious complication of untreated sinusitis. IBD patients on biologics can have higher risk of developing such complications because of their decreased ability to fight infections. Although the risk of serious infections declines significantly after the first year of using biologics, physicians should keep a low threshold for investigating symptomatic patients for serious infections, as they require prompt intervention. Despite the potential complications from using biologics, the benefits of this therapy in IBD patients outweigh the risks.

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“…Pott's puffy tumour usually develops as a complication of chronic or acute frontal sinusitis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) . In most cases, the diagnostic process reveals inflammation of more than one sinus, with maxillary and ethmoidal sinuses being a common location.…”

Section: Aetiologymentioning

confidence: 99%

“…The frontal sinus becomes radiographically visible between 6 and 8 years of life (5,11) . Pott's puffy tumour usually develops as a complication of spreading frontal sinusitis leading to frontal bone marrow inflammation (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) . The direct anterior spread of frontal sinus infection causes destruction of the frontal bone cortex and subperiosteal collection of purulent content, which results in a distinct swelling in the frontal region.…”

Section: Pathogenesismentioning

confidence: 99%

Paranasal sinusitis complicated by Pott’s puffy tumour

Przybysz¹,

Hartmann²,

Jackowska³

2018

PEDIATR MED RODZ

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Pott's puffy tumour is defined as inflammation of the frontal bone marrow with an accompanying subperiosteal abscess manifested by swelling of the frontal region and is most often a complication of paranasal sinusitis or trauma. Early diagnosis and implementation of proper treatment are important due to the frequent co-occurrence of intracranial complications, such as epidural empyema, cerebral abscesses or meningitis. Due to the low prevalence of Pott's puffy tumour, the knowledge on this severe complication relies on descriptions or series of cases, especially among children. We present a case of an 8-year-old girl who was admitted to the hospital due to headache and swelling in the frontal area. We also present a summary of the available publications on Pott's puffy tumour. Diagnostic procedures revealed massive inflammatory changes in the paranasal sinuses, with the destruction of the frontal sinus walls, and showed a connection between the inflammatory lesions and the anterior cranial fossa. The girl was qualified for urgent neurosurgical and laryngological surgery.

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Pott's puffy tumor in a 12‐year‐old boy

Cited by 13 publications

References 8 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 in an Inflammatory Bowel Disease Patient on Anti-TNF Therapy

Paranasal sinusitis complicated by Pott’s puffy tumour

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