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Pott's puffy tumour: innovative technique in calvarial reconstruction

Published online by Cambridge University Press:  07 October 2019

B Mettias ,
G Dow ,
D Srinivasan  and
Y Ramakrishnan
B Mettias*
Affiliation:
Department of ENT, Queen's Medical Centre, Nottingham University Hospitals, UK
G Dow
Affiliation:
Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals, UK
D Srinivasan
Affiliation:
Oral and Maxillofacial Surgery, Queen's Medical Centre, Nottingham University Hospitals, UK
Y Ramakrishnan
Affiliation:
Department of ENT, Queen's Medical Centre, Nottingham University Hospitals, UK
*
Author for correspondence: Mr Bassem Mettias, ENT Department, Queen's Medical Centre, Derby Rd, Nottingham NG7 2UH, UK E-mail: [email protected]
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Abstract

Background

Pott's puffy tumour is a rare complication of sinusitis. This osteomyelitis can affect the outer and inner tables of the frontal sinus. The treatment of Pott's puffy tumour combines medical and surgical approaches. Surgical approaches have traditionally been open, but endoscopic techniques have been adopted recently in select cases. The bony defect from debridement can be left alone, or closed with autografts or allografts.

Objective

To describe a technique for the reconstruction of a large skull vault after the debridement of extensive osteomyelitis of the anterior cranial vault.

Methods

Modified distraction osteogenesis is used in the cranial vault, to induce new bone formation. This is customarily used to lengthen long bones. The advantages of this technique include avoiding autologous grafts or alloplastic cranioplasty in the infected surgical bed, and allowing primary closure.

Results

Early post-operative imaging results have been encouraging, with no reported complications.

Conclusion

Modified distraction osteogenesis is a novel technique in the primary reconstruction of calvarial bone.

Keywords

Frontal BoneOsteomyelitisPott's Puffy TumorReconstructive Surgical ProceduresTissue Expansion Devices
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 11 , November 2019 , pp. 1005 - 1008
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Mr B Mettias takes responsibility for the integrity of the content of the paper

References

1Marshall, AH, Jones, NS. Osteomyelitis of the frontal bone secondary to frontal sinusitis. J Laryngol Otol 2000;114:944–6Google Scholar
2Sharma, P, Sharma, S, Gupta, N, Kocher, P, Kumar, Y. Pott puffy tumor. Proc (Bayl Univ Med Cent) 2017;30:179–81Google Scholar
3Akiyama, K, Karaki, M, Mori, N. Evaluation of adult Pott's puffy tumor: our five cases and 27 literature cases. Laryngoscope 2012;122:2382–8Google Scholar
4Lawson, W, Reino, A, Deeb, R. The Riedel procedure - an analysis of 22 cases. Arch Otolaryngol Rhinol 2017;3:087–092Google Scholar
5Agrawal, A, Garg, LN. Split calvarial bone graft for the reconstruction of skull defects. J Surg Tech Case Rep 2011;3:13–16Google Scholar
6Jung, J, Lee, HC, Park, I, Lee, HM. Endoscopic endonasal treatment of a Pott's puffy tumor. Clin Exp Otorhinolaryngol 2012;5:112–15Google Scholar
7Cho-Lee, GY, Naval-Gías, L, González-García, R, Martos-Díaz, PL, Muñoz-Guerra, MF, Sastre-Pérez, J et al. Bifocal transport osteogenesis for the reconstruction of adult calvarial defects: a new surgical technique. J Craniomaxillofac Surg 2010;38:368–73Google Scholar
8Lauria, RA, Fernandes, FL, Brito, TP, Pereira, PSG, Chone, CT. Extensive frontoparietal abscess: complication of frontal sinusitis (Pott's puffy tumor). Case Rep Otolaryngol 2014;632464Google Scholar
9Andrabi, SM, Sarmast, AH, Kirmani, AR, Bhat, AR. Cranioplasty: indications, procedures, and outcome - an institutional experience. Surg Neurol Int 2017;8:91Google Scholar
10Verbon, A, Husni, RN, Gordon, SM, Lavertu, P, Keys, TF. Pott's puffy tumor due to Haemophilus influenzae: case report and review. Clin Infect Dis 1996;23:1305–7Google Scholar
11McCarthy, JG, Schreiber, J, Karp, N, Thorne, CH, Grayson, BH. Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 1992;89:1–8Google Scholar
12Ong, J, Harshbarger, RJ, Kelley, P, George, T. Posterior cranial vault distraction osteogenesis: evolution of technique. Semin Plast Surg 2014;28:163–78Google Scholar
13White, N, Evans, M, Dover, MS, Noons, P, Solanki, G, Nishikawa, H. Posterior calvarial vault expansion using distraction osteogenesis. Childs Nerv Syst 2009;25:231–6Google Scholar