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Abnormal Skull
Published in Swati Goyal, Neuroradiology, 2020
Lesions involving ACF include sincipital encephalocele, benign sinonasal masses, such as polyps, hemangiomas, inverted papillomas, inflammatory mucosal disease, juvenile nasopharyngeal angiofibromas, and malignant masses, including sinonasal malignancy and olfactory neuroblastoma. Frontal bone osteomyelitis extends outward, forming a subgaleal abscess (Pott’s puffy tumor), and is an infective lesion of the region. Traumatic fracture of the cribriform plate and the crista galli can result in CSF rhinorrhea.
Otorhinolaryngology (ENT)
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Complications of sinusitis➣ Orbital complications - Chandler’s classificationPreseptal cellulitisOrbital cellulitisSubperiosteal abscessOrbital abscessCavernous sinus thrombosis➣ Pott’s Puffy tumorA life threatening complicationOsteomyelitis of the frontal bone with subperiosteal abscess causing swelling and edema over the forehead and scalp.➣ Intracranial complicationsMeningitisExtradural abscessSubdural abscessBrain abscessCavernous sinus thrombosis➣ MucoceleAccumulation of sterile mucus with increased viscosityExpansion of cyst can cause bony erosion and displacement of adjacent structures such as the orbitDiagnosis on CT
Frontal sinus abscess with cutaneous fistula secondary to Streptococcus constellatus
Published in Orbit, 2021
William Carrera, William B Lewis, Rona Z Silkiss
A 49 year-old man presented with a several-day history of right upper eyelid swelling and purulent discharge. He had a history of inhalational heroin use. Examination noted intact visual acuity, proptosis, lateral globe displacement, and a cutaneous fistula. MRI revealed an anterior orbital and right frontal sinus abscess with bony erosion of the walls of the frontal sinus and the superior orbital rim (Figure 1). He underwent drainage of the abscess and treatment with intravenous vancomycin, ceftriaxone, and metronidazole. He demonstrated rapid and marked improvement. Cultures taken at the time of drainage grew Streptococcus constellatus. Streptococcus constellatus, a member of the Streptococcus anginosus Group (SAG), is a commensal organism of the mucous membranes, but may form abscesses, commonly of the abdomen and respiratory tract. Orbital involvement of Streptococcus constellatus has been reported in association with Pott’s puffy tumor, orbital cellulitis, and cavernous sinus thrombosis and in one case with frontal sinus abscess. To our knowledge, neither frontal sinus cutaneous fistula nor an association with heroin inhalation has been previously described. Recent epidemiologic studies have suggested that SAG organisms are a significantly under-appreciated cause of orbital abscess and complicated sinusitis.
Trauma-associated Pott’s puffy tumor: an ophthalmologic perspective
Published in Orbit, 2020
Shahzeb Hassan, Bahram Rahmani, Jeffrey C. Rastatter, Alok I. Jaju, Sudhi P. Kurup
Originally described by Sir Percival Pott in 1760, Pott’s puffy tumor (PPT) is a frontal swelling associated with osteomyelitis of the frontal bone.1 It is usually associated with subperiosteal abscess, which can be caused by infection of the anterior plate of the frontal bone (from underlying frontal sinusitis). PPT can also be triggered by trauma to the frontal bone, but these cases are more rare.2 Typically, PPT presents in adolescent patients because this is the peak time for vascularity development of the diploic veins, which are responsible for draining the frontal sinus.3 Patients can present with headache, fever, nausea, vomiting, and seizures. Therefore, attention should be given toward adolescents presenting with the aforementioned symptoms after antecedent infection or head trauma. Computed tomography is typically the method for diagnosing the underlying frontal osteomyelitis and associated abscess.3
Fusobacterium necrophorum-induced orbital cellulitis with intracranial involvement: a case report and review of the literature
Published in Orbit, 2022
Tal Koval, Samantha Hunt, Helen Garrott, Rebecca Ford
Known intracranial complications of orbital cellulitis include meningitis, epidural or subdural empyema or abscess, intracerebral abscess, subperiosteal abscess associated with frontal osteomyelitis (Pott’s puffy tumor), cavernous sinus thrombosis and ischemic brain infarction.1 Although half of the patients presented here with F. necrophorum-induced orbital cellulitis showed intracranial complications, these complications are usually considered rare and account for only 4% of hospitalized patients with sinusitis.1