Pott's puffy tumor in pediatric Patients: Our surgical experience

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY
Udi Shapira , Fares Butrus , Nidal Muhanna , Avraham Abergel , Forsan Jahshan
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引用次数: 0

Abstract

Background

Pott's puffy tumor (PPT) is a rare complication of frontal sinusitis defined as subperiosteal abscess of the anterior table of the frontal sinus with associated osteomyelitis. Its complications can be harmful to the patient, therefore immediate treatment is necessary. Surgical drainage and systemic antibiotics are considered as integral parts of the overall treatment. However, surgical approaches can differ between different centers and surgeons.

Methods

We retrospectively evaluated the electronic records of 13 pediatric patients with PPT between 2018 and 2023.Clinical, laboratory radiology, and demographic findings were evaluated as well as surgical and post op data.

Results

Thirteen patients were included in the study (M/F: 7/6), the median age was 11.3 (6–15) years old. eight (61.5 %) patients had an intracranial complication. All patients were treated with intravenous antibiotics. One patient was treated conservatively and the other 12 were operated on. In the first operation 3/12 (25 %) underwent only frontal sinus trephination, 5/12 (41.66 %) underwent endoscopic sinus surgery (ESS) and 4/12 (33.33 %) underwent combined endoscopic and trephination surgery. Repeated surgery was needed for 5 patients, four of them underwent only endoscopic drainage and one underwent combined endoscopic and trephination surgery. The media hospitalization time (days) after the 1st surgical intervention was 8.3 for the combined approach, 9.6 for the external approach and 14.75 for the endoscopic approach. All patients recovered uneventfully.

Conclusions

Herein, we report our surgical experience in pediatric patients with PPT treated in a tertiary hospital. Ideally, PPT should be managed with a combination of broad-spectrum antibiotic therapy and surgical intervention.
Traditionally, open approaches served as the primary surgical route to access frontal sinus in PPT patients. However, the emergence of endoscopes instrumentation has supplemented these approaches in dealing with PPT. Our database reveals that open approach still has an important role in PPT treatment as patients who underwent only endoscopic drainage faced a higher risk of inadequate improvement and necessitating reintervention.
小儿波特氏膨胀性肿瘤:我们的手术经验
背景:pott 's puff性肿瘤(PPT)是额窦炎的一种罕见并发症,定义为额窦前表的骨膜下脓肿并伴有骨髓炎。其并发症可能对患者有害,因此需要立即治疗。手术引流和全身抗生素被认为是整体治疗的组成部分。然而,不同的中心和外科医生的手术方法可能不同。方法回顾性分析2018 - 2023年13例小儿PPT患者的电子病历。评估临床、实验室放射学和人口统计学结果以及手术和术后数据。结果共纳入13例患者(M/F: 7/6),中位年龄为11.3(6-15)岁。8例(61.5%)患者出现颅内并发症。所有患者均静脉注射抗生素。1例保守治疗,其余12例手术治疗。在第一次手术中,3/12(25%)只行额窦穿刺,5/12(41.66%)行鼻内窥镜手术(ESS), 4/12(33.33%)行鼻内窥镜联合穿刺手术。5例患者需要重复手术,其中4例仅行内镜引流,1例行内镜联合穿刺手术。首次手术干预后,联合入路的平均住院时间(天)为8.3天,外入路为9.6天,内镜入路为14.75天。所有患者均顺利康复。结论我们报告了在某三级医院治疗小儿PPT的手术经验。理想情况下,应结合广谱抗生素治疗和手术干预来治疗PPT。传统上,开放入路是PPT患者进入额窦的主要手术途径。然而,内窥镜仪器的出现补充了这些处理PPT的方法。我们的数据库显示,开放入路在PPT治疗中仍然发挥着重要作用,因为仅行内镜引流的患者面临着改善不足和需要再次干预的更高风险。
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来源期刊
CiteScore
3.20
自引率
6.70%
发文量
276
审稿时长
62 days
期刊介绍: The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.
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