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Neurosurgical implications of Pott's puffy tumor in children and adolescents
J Francisco Salomão1, Tatiana Protzenko Cervante, Antonio R Bellas
1Section of Pediatric Neurosurgery, Department of Pediatric Surgery, Fernandes Figueira National Institute for Health of Woman, Child and Adolescent, Oswaldo Cruz Foundation (IFFFiocruz), Av. Rui Barbosa, 716, 22250-020, Rio de Janeiro, RJ, Brazil, jfsalomao@terra.com.br.
Insights
Pott's puffy tumor (PPT), a rare complication of frontal sinusitis, can cause serious intracranial issues. Prompt treatment, surgical or conservative, led to full recovery in all pediatric cases studied.
Area of Science:
- Otolaryngology
- Pediatric Neurosurgery
- Infectious Diseases
Background:
- Pott's puffy tumor (PPT) is a rare subperiosteal abscess of the frontal bone, often a complication of frontal sinusitis.
- It can be associated with underlying osteomyelitis and lead to severe intracranial complications.
Purpose of the Study:
- To report on pediatric cases of Pott's puffy tumor with intracranial complications.
- To review the clinical presentation, management, and outcomes of these rare cases.
Main Methods:
- Retrospective case series of six pediatric patients diagnosed between 1999 and 2012.
- Evaluation of clinical presentation, diagnostic findings, and treatment strategies.
Main Results:
- All six patients presented with frontal swelling, headache, and fever; two had altered consciousness and hemodynamic instability.
- Epidural abscess was present in all cases; one also had subdural empyema.
- Five patients underwent surgical intervention (abscess drainage, bone resection, sinusitis treatment); one was managed conservatively with antibiotics. All patients achieved full neurological recovery.
Conclusions:
- Pott's puffy tumor in children, though rare, requires prompt diagnosis and management.
- Both surgical and conservative approaches can lead to successful outcomes, with complete neurological recovery observed in this series.
Introduction:
Pott's puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis. PPT is potentially severe and can lead to life-threatening intracranial complications.
Patients And Methods:
The authors present a series of six pediatric patients diagnosed with PPT and intracranial complications between 1999 and 2012. There were five boys and one girl, and the mean age at diagnosis was 11.8 years. All patients presented with frontal swelling, headache, and fever. Two patients had lowered level of consciousness and severe hemodynamic instability.
Results:
All patients had epidural abscess, and one also presented subdural empyema. Five patients underwent drainage of all associated abscesses, bone resection, and sinusitis treatment. One was treated conservatively with broad-spectrum antibiotics, and no surgical intervention was required. All patients fully recovered their neurologic status, without further complications.
