Pott's puffy tumor is
Sub periosteal abscess of frontal bone
Sub periosteal abscess of ethmoid bone
Mucocele of frontal bone
Mucocele of ethmoid bone
POTT'S PUFFY TUMOUR It is formation of diffuse external swelling in the scalp due to subperiosteal pus formation (abscess) and scalp oedema. x It originates commonly in frontal region and may extend into other regions. x There is acute osteomyelitis of frontal bone. Causes x Chronic frontal sinusitis which eventually suppurates and extends into subperiosteal region. x Trauma--subperiosteal haematoma. x Chronic suppurative otitis media. Features x Pain and boggy swelling in frontal region which is warm, tender. x Toxicity and drowsiness. x Pitting scalp oedema is typical. x Investigations:  Total leucocyte count--increased. ESR--raised.  X-ray skull. CT scan. x Differential diagnosis: Secondaries in the skull or brain. Complications Osteomyelitis of frontal bone. Spread of infection into intracranial cavity leads to intracranial abscess (Extradural or subdural abscess) (dumb-bell abscess). So may present with features of raised intracranial tension like headache, coning and convulsions. Pott's Puffy tumor can be associated with coical vein throm- bosis, epidural brain abscess/subdural empyema. The cause of vein thrombosis is explained by diplopic veins in frontal bone, which communicates with the dural venous plexus; septic thrombi can potentially evolve from foci within the frontal sinus and propagate through this venous system. Treatment x Antibiotics and drainage under general anaesthesia before it spreads into cranial cavity. x Once it extends into cranial cavity, it is treated accordingly by formal neurosurgical decompression (often using Dandy's brain cannula). x Osteomyelitis of skull bones requires radical removal with recon- struction of skull defect. Ref: SRB manual of surgery 5th edition Pgno: 48
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