A Case of Pott's Puffy Tumor from Odontogenic Source

Pott's puffy tumor (PPT) is a known complication of frontal sinusitis. Odontogenic maxillary sinusitis can seldomly spread to involve the frontal sinus but has not been implicated in the development of PPT. Herein, we describe a case of frontal sinusitis originating from an odontogenic source and culminating in PPT.

A new way to treat frontal sinusitis. D. Hanmen and B. Russell. (The Journ.of Laryngol. Otolog. 1931)

Hanmen and B. Russell. (The Journ.of Laryngol. Otolog. 1931) propose a new treatment for frontal sinusitis. The reason for the application of this method was the following circumstance.

Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy

Introduction Conventional functional endoscopic sinus surgery (FESS) for frontal sinusitis treatment involves ethmoidal bullectomy, that is associated with damage to the surrounding structures. These complications can be overcome by minimally invasive FESS anterior to the ethmoidal bulla that allows ease in locating the sinus ostium, eliminating risk of injury to anterior skull base and nearby structures. This study aims to compare the efficacy of ethmoidal bullectomy versus intact ethmoidal bulla technique as an adjunct to FESS in frontal sinusitis management. Materials and Methods Forty patients, clinically and radiologically diagnosed with frontal sinusitis, were randomly divided into 2 groups: Group A (n=20; treated with FESS keeping the ethmoidal bulla intact) and Group B (n=20; treated using FESS with ethmoidal bullectomy). After detailed history and clinico-radiological examinations, diagnostic nasal endoscopy was performed, followed by FESS. Pre- and post-operative endoscopic and clinical assessment was done using Modified Lund-Kennedy Endoscopy (MLKE) Score and Sino-Nasal Outcome Test-22 (SNOT-22) Questionnaire, respectively. Data was analyzed using software R version 3.6.3. Results Significant reductions in SNOT-22 (clinical improvement) and MLKE scores (endoscopic improvement) were seen within the groups from baseline to each follow-up visit and between the successive recall visits (p<0.001). The SNOT-22 and MLKE scores were insignificant at any visit between the groups, along with age distribution, gender and intra-operative complications (p>0.05). Complications were seen only in Group B. Conclusion Both, ethmoidal bullectomy and intact ethmoidal bulla technique, when used as adjuncts to FESS, showed similar improvements in frontal sinusitis patients. However, bullectomy was associated with greater risk of intra-operative complications.

Computed Tomography Analysis of the Anterosuperior Portion of the Bulla Lamella in Chinese Subjects and Its Surgical Significance in Endoscopic Frontal Sinusotomy

<b><i>Introduction:</i></b> The anterosuperior portion of the bulla lamella can extend into the frontal sinus and form the supra bulla frontal cell (SBFC) and supraorbital ethmoid cell (SOEC). This can affect the frontal drainage pathway and make surgery more challenging. <b><i>Objectives:</i></b> The aim of the study was to compare the anatomical characteristics of SBFC and SOEC in Chinese chronic rhinosinusitis (CRS) patients and explore the relationship between the cells and frontal sinusitis (FS). The surgical skills in dealing with these cells were also studied. <b><i>Methods:</i></b> We prospectively identified SBFC and SOEC in 114 patients with CRS by computed tomography (CT). The sides of the patients were divided into groups A (with FS) and B (without FS). CT scans were analyzed to distinguish the SBFC, SOEC, and the drainage pathway. Statistical analysis was conducted to determine whether the cells were associated with the occurrence of FS. <b><i>Results:</i></b> The prevalence of frontal cells was as follows: SBFC: 9.65%, SOEC: 21.93%. There was an association between the presence of SBFC and FS (<i>p</i> &#x3c; 0.05). The anterior drainage pathway was present in patients with SBFC and SOEC, anterolateral pathway in those with SBFC/SOEC coexisting with the frontal septal cell, and anteromedial pathway in those with SBFC/SOEC coexisting with the supra agger frontal cell. <b><i>Conclusions:</i></b> There was an association between the presence of SBFC and the occurrence of FS. Extension of the anterosuperior portion of the bulla lamella into the frontal sinus obstructed the drainage pathway posteriorly. Understanding the anatomy may help surgeons thoroughly dissect the bulla lamella.

Pott's puffy tumor: as a very rare and unpredicted complication of ipsilateral pan sinusitis - case presentation and review of articles

Pott's puffy tumor is considered as a rare clinical entity. It is developed as a rare complication of frontal sinusitis. In addition, the trauma to the frontal area is another suggested cause. The Pott's puffy tumor is presented as a forehead swelling due to sub-periosteal collection. Although, the Pott's puffy tumor is a rare condition but at the same time, it can be serious because it may lead to life threatening complications namely, extradural abscess, subdural abscess, meningitis, encephalitis, and brain abscess. Thus, the Pott's puffy tumor is classified as a very significant surgical emergency.

A RARE COMPLICATION POTT’S PUFFY TUMOR TREATED WITH FRONTOETHMOIDECTOMY: A CASE REPORT

Untreated or undiagnosed frontal sinusitis develops as a subperiosteal abscess in the frontal bone named Pott’s puffy tumor (PPT). Pott’s puffy tumor is a rare complication that needs surgical excision. In this communication, we report a 50-year-old woman presenting with typical signs and symptoms of PPT. CT-Scan and X-ray imaging are the gold standards to measure the extent of tumor and involvement of structures, if any.

Pott’s Puffy Tumor

Pott’s puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be managed with a combination of open and endoscopic sinus surgery and intravenous antibiotic therapy. In the current report, a 15-year-old male presented with a classic case of Pott’s puffy tumor which was managed with bilateral ethmoidectomies, frontal sinusotomies, and frontal sinus trephination, resulting in discharge on intravenous antibiotic therapy and subsequent complete resolution of symptoms.

CLINICAL STUDY ON SHIREESHADI AVAPEEDANA NASYA IN THE MANAGEMENT OF SURYAVARTHA (FRONTAL SINUSITIS)

Nasya karma is considered a prime treatment modality in all types of Shiroroga (Headache) and also in Suryavar- tha (Frontal Sinusitis). Suryavartha (Frontal Sinusitis) is one of the 11 types of Shiroroga. It is one of the com- mon clinical conditions found in day to day general as well as Shalakya (ENT) practice. It presents with headache as one of its cardinal features and its occurrence is found in both genders and in all age groups. Objective: To study the efficacy of Shireeshadi Avapeedana Nasya in the management of Suryavartha (Frontal Sinusitis). Ma- terial methods: Twenty patients of Suryavartha (Frontal Sinusitis) were diagnosed and registered for the clinical study irrespective of sex, socio-economic status, and religion. The study was divided into two groups - Group A and Group B. Group – A patients were treated with Shireeshadi Avapeedana Nasya for 7 days and Group – B patients were treated by Nasya with milk for 7 days. Observation and result: Among 20 patients of Suryavartha / frontal sinusitis, 20 (100%) of patients had headache, 11 (55%) had nasal blockage, 05 (25%) had nasal dis- charge, 08 (40%) had foul smell in their breath and 14 (70%) have variations from normal X-Ray. The severity of headache is significantly reduced after treatment in both Groups A and B (92.95% and 73.07%) respectively. Conclusion: Administration of Shireeshadi Avapeeda Nasya showed statistically significant improvement in the management of Suryavartha (Frontal Sinusitis). Keywords: Suryavartha, Nasya, Shireeshadi Avapeedana Nasya, Frontal Sinusitis, Shigru, Mulaka, Ksheera.