Pott's Puffy Tumor and Intracranial Complications

Pott’s puffy tumour is a rare but serious sequela of frontal sinusitis, characterised by osteomyelitis of the frontal bone and a subperiosteal abscess presenting as a fluctuant forehead swelling. Although historically described more than two centuries ago, its incidence has resurged in parallel with delays in sinusitis diagnosis and rising antimicrobial resistance. The infection may breach the posterior table of the frontal sinus, allowing spread into the epidural or subdural spaces, and in some cases precipitating meningitis, cerebral abscess or cavernous sinus thrombophlebitis. Clinical features include fever, headache, periorbital oedema and neurological signs, while imaging with contrast‐enhanced computed tomography (CT) or magnetic resonance imaging (MRI) is essential to delineate bony erosion and intracranial collections. Management hinges on prompt broad‐spectrum antibiotics tailored to culture results and timely surgical intervention, typically combining endoscopic sinus surgery with open drainage where necessary. Multidisciplinary collaboration among otolaryngologists, neurosurgeons and infectious disease specialists is critical to minimise morbidity and prevent long-term neurological deficits.

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Pott's Puffy Tumor and Intracranial Complications publication trend

The graph below shows the total number of articles in pott's puffy tumor and intracranial complications across all publications each year (not limited to Nature Index journals).

Technical terms

Pott’s puffy tumour: Frontal bone osteomyelitis with overlying subperiosteal abscess associated with sinusitis.

Osteomyelitis: Infection and inflammation of bone marrow and adjacent bone tissue.

Subperiosteal abscess: Collection of pus beneath the periosteum of a bone.

Frontal sinusitis: Inflammation or infection of the frontal paranasal sinus.

Epidural abscess: Pus accumulation between the dura mater and the skull.

Subdural empyema: Purulent material located between the dura and arachnoid mater.

Cerebral abscess: Localised intracerebral collection of pus within brain parenchyma.

Meningitis: Inflammation of the meninges, the protective membranes covering the brain and spinal cord.

References

1. A Systematic Review of Intracranial Complications in Adults with Pott Puffy Tumor over Four Decades. Brain Sciences (2023).
2. Pott’s puffy tumor: a need for interdisciplinary diagnosis and treatment. HNO (2022).
3. Pott’s Puffy Tumor Presenting as Pyogenic Meningitis in an Infant. Case Reports in Pediatrics (2022).
4. Pott’s puffy tumor: ct and mri findings. Journal of the Belgian Society of Radiology (2011).