Pott’s puffy tumor is mainly characterized by the occurrence of osteomyelitis of the frontal bone of the scalp associated directly or along with haematogenic spread resulting in the localized inflammation of the forehead. This infection is very likely to spread inwardly resulting in the formation of intracranial abscess which in many cases can be associated with the cortical vein thrombosis, epidural abscess, subdural empyema, and brain abscess.
In 1760, this tumor was firstly introduced by Sir Percivall Pott and so was named after his name.
Diagnosis is performed by critically examining the CT and MRI scans of the patients. However, the occurrence of early indications including headache and inflammation of the forehead is mandatory to lead towards the more critical examination of the condition. Proper diagnosis is very important to lead the rational treatment of this condition. This tumor is very rare nowadays due to the advanced therapies of antimicrobial drugs which have limited the progression of the disease.
Moreover it can be developed in any age but the most vulnerable era is considered early childhood adolescence due to the advanced vascularization in the area of frontal sinus in the diploic transmission that allows the quick spread of infections.
Pott’s Puffy Tumor Pictures Pictures
Proper CT and MRI scans are suggested to understand the condition of the patient. Here are some pictures that describe the condition of the disease graphically.
1. Nasoendoscopy examination: CT scan of the head area is presenting the defects in the frontal bone as well as the inflammation of soft tissues in this area. Moreover the opacifications can be observed in many areas including; left and right maxillary sinuses, left frontal sinus, and left ethmoid sinus(Fig 1).
Fig 1: MSCT kepala irisan axial tanpa kontras.
2. CT scan examination: There are visible lytic lesions associated with hyperostosis in many specified areas including; anterior wall posterior left frontal sinus, left anterior sinus ethmoidal left wall, anterior left lateral sinus left sinus wall (Fig 2).
Figure 2: CT scan kepala evaluasi.
Pott’s Puffy Tumor Symptoms
Generally it is characterized by the inflammation of the specified area of the forehead that is associated with the development of osteomyelitis of the frontal bone as well as the accumulation of underlying subperiosteal abscess. Some common symptoms of this disorder may involve;
● Inflammation of the frontal portion of the scalp or forehead
● Elevated body temperature (fever)
● Nasal drainage
● Photophobia ( the fear or discomfort for the photography)
● Soreness or stiffness of the frontal sinus
● Pott’s puffy tumor is a complication of frontal sinus disease or direct injury to the frontal bone.
Major symptoms among the above stated clinical manifestations are headache and fever but do not pose any associated symptoms of rhinosinusitis. But these can also occur along with associated other rhinosinusitis complications.
Pott’s Puffy Tumor Causes
There are some underlying reasons explained by the professionals and researchers which may include;
● Frontal sinusitis, that can be acute or chronic in condition.
● Frontal trauma, which is usually characterized as blunt.
● Some serious cases of intranasal substance abuse (especially cocaine and methamphetamine) are considered the most vulnerable candidates in the context of this disease.
● Post-surgical conditions of frontal sinus reconstructions may lead to the development of this disease.
Pott’s Puffy Tumor Treatment
Pott’s Puffy Tumor is described as an indicator of the development of potential infections which can be posed life-threatening and it involves a high association of larger mortality and morbidity rates. Meanwhile the estimated mortality rate of this disease is approximately 12% followed by increased intracranial pressure, ischemia, thrombosis, and sepsis.
There are many treatment options to manage this condition which requires a proper understanding of the condition of the patients and disease. The major treatment goal is to avoid the risks of any kind of intracranial complications.
● Antibiotic therapy: Commonly, the intravenous administration of antimicrobial medications is suggested in mild to moderate cases involving good insertion in CNS for a period of approximately 04 to 06 weeks. These medications may involve; clindamycin, ceftriaxone, metronidazole, vancomycin.
● Drainage therapy: Ultimately, the drainage of the abscess is carried out by using either open or endoscopic techniques or their combinations which truly depend upon the surgical skills of the professional.
● In rare and emergency cases, the abscess is externally trephined and the occurrence of any associated fractures in the frontal sinus is managed exclusively.
● Intracranial extensions can also be implemented by it requires a more complicated procedure that cannot be carried out without consultation from the neurosurgical department. As well as to achieve the aim of the treatment proper cooperation of different departments is highly suggested involving otorhinolaryngologists, neurosurgeons, and ophthalmologists.
Proper follow-up should be carried out along with regular MRI and CT scans.