Periorbital cellulitis, subperiosteal abscess, and sinusitis

Pott’s puffy tumor (PPT) is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess presenting as frontal swelling. It was first described by Sir Percival Pott in 1768 in relation to frontal head trauma. Later, it was established that this entity is more common in relation to frontal sinusitis (1). In this article we report a case of PPT in a 17-year-old boy. CT scan confirmed subperiosteal abscess. At surgery, the subperiosteal abscess was drained and sequestrectomy of the affected frontal bone was done. Broad-spectrum antibiotics were given for 4 weeks. The patient recovered without residual problems and has remained well. PPT is now relatively uncommon and early diagnosis and prompt treatment is necessary to avoid further intracranial complications, which can be life-threatening.

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Post-operative fever in children undergoing mastoidectomy due to complicated acute mastoiditis

10.22541/au.161460308.88672642/v1 ◽

2021 ◽

Author(s):

Oren Ziv ◽

Aviad Sapir ◽

Eugene Leibowitz ◽

Sofia Kordeluk ◽

Daniel KAPLAN ◽

...

Keyword(s):

Chart Review ◽

Tertiary Care ◽

Retrospective Chart Review ◽

University Hospital ◽

Acute Mastoiditis ◽

Benign Condition ◽

Subperiosteal Abscess ◽

Cortical Mastoidectomy ◽

New Findings ◽

Mastoid Surgery

Abstract Objectives: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) following surgical treatment. Study Design: A retrospective chart review of children diagnosed with CAM who underwent mastoid surgery during 2012-2019. Setting: Tertiary care university hospital. Participants: the study includes 33 patients, divided into two groups: 17 patients with subperiosteal abscess (SPA) alone - single complication group (SCG) and 16 patients with SPA and additional intracranial or intratemporal complications -multiple complications group (MCG). Main Outcome Measures: post-operative fever course and pattern (POF). Results :33 patients belong to the SCG 17(51%) and 16(49%) belonged to the MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P=0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings. Conclusion: Following a cortical mastoidectomy for CAM, POF is not unusual in the first 6 days and seem to be benign condition. POF is more common, higher, and persistent for a longer duration in MCG compared with SCG. At POD 6, fever is expected to normalize in both groups, so if fever persists further evaluation should be considered.

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Subperiosteal abscess in a child. Trueta's osteomyelitis hypothesis undermined?

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2015.07.005 ◽

2015 ◽

Vol 101 (6) ◽

pp. 763-765 ◽

Cited By ~ 4

Author(s):

S.G.M. Weenders ◽

N.E. Janssen ◽

G.W.D. Landman ◽

F.P. van den Berg

Keyword(s):

Subperiosteal Abscess

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Endoscopic Drainage of Subperiosteal Abscess in Children: A Pilot Study

American Journal of Rhinology ◽

10.2500/105065896781795157 ◽

1996 ◽

Vol 10 (1) ◽

pp. 11-16 ◽

Cited By ~ 7

Author(s):

Ramzi T. Younis ◽

Rande H. Lazar

Keyword(s):

Nasal Spray ◽

Endoscopic Surgery ◽

Traditional Approach ◽

Maxillary Sinusitis ◽

Signs And Symptoms ◽

Sinus Surgery ◽

High Dose ◽

Endoscopic Drainage ◽

Subperiosteal Abscess ◽

External Incision

Subperiosteal abscess is a serious orbital complication of sinusitis that occurs predominantly in children. Infection may spread to the orbital site through a preexisting defect in the lamina papyracea or by means of a thrombophlebitic process. Although the traditional approach to treating a subperiosteal abscess has been drainage through an external incision, we treated this serious complication with functional endonasal sinus surgery. Ten pediatric patients with clinical and CT evidence of orbital subperiosteal abscess underwent endoscopic surgery at LeBonheur Children's Hospital in Memphis, Tenn., between July 1990 and June 1992. The four girls and six boys were between 3 and 12 years of age at the time of surgery. Despite 2 to 4 days of intravenous antibiotic therapy, their signs and symptoms progressed, and axial and coronal CT scans demonstrated orbital subperiosteal abscess. Seven patients had bilateral ethmoid and maxillary sinusitis, and the remaining three patients had unilateral ethmoiditis. Ophthalmologic assessments were performed for all patients immediately after hospital admission. The patients were started on regimens of high-dose intravenous cefuroxime sodium to subdue infections and pediatric decongestant nasal spray to facilitate drainage. All 10 patients with the confirmed diagnosis of subperiosteal abscess were treated with endoscopic surgery to drain the site of infection. All 10 patients improved significantly 12 to 24 hours after surgery and were discharged from the hospital to their homes 48 to 72 hours after surgery. Patients were continued on a regimen of broad-spectrum oral antibiotics and beclomethasone nasal spray for 2 weeks beyond the final examination. Follow-up endoscopic examinations were performed under general anesthesia in the operating room 2 to 3 weeks after surgery. No complications or adverse sequelae occurred. Our study appears to confirm that endoscopic drainage of subperiosteal abscess offers the patient an alternative to incisional surgery. The endoscopic approach prevents an external scar without increasing morbidity or length of hospitalization.

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Nonsurgical management of subperiosteal abscess of the orbit: Author’s reply

Ophthalmology ◽

10.1016/s0161-6420(00)00628-x ◽

2001 ◽

Vol 108 (7) ◽

pp. 1168-1169

Author(s):

Gerald J Harris ◽

George H Garcia

Keyword(s):

Subperiosteal Abscess ◽

Nonsurgical Management

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