Domville-Lewis C, Friedland P L, Santa Maria P L
Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
J Laryngol Otol. 2013 Jan;127 Suppl 1:S35-8. doi: 10.1017/S0022215112001673. Epub 2012 Aug 15.
A Pott's puffy tumour is a subperiosteal abscess and osteomyelitis of the frontal bone secondary to frontal sinusitis. Intracranial complications are seen in approximately 40 per cent of cases and are potentially life-threatening; such complications have not previously been reported in pregnancy.
A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. Imaging confirmed Pott's puffy tumour with right-sided epidural empyema and periorbital cellulitis. A multidisciplinary team was involved in the patient's management. Intravenous antibiotics were commenced and initial percutaneous drainage through the frontal sinus skin was performed, followed by endoscopic sinus drainage. A caesarean section was performed 3 days later. Complete resolution of the sinus and intracranial collections was noted on imaging performed six weeks later.
This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.
波特氏浮肿性肿瘤是继发于额窦炎的额骨骨膜下脓肿和骨髓炎。约40%的病例会出现颅内并发症，且可能危及生命；此前妊娠期间尚未有此类并发症的报道。
一名孕35周的21岁女性，有额部头痛、肿胀、眶周水肿、疼痛和球结膜水肿的病史。影像学检查确诊为波特氏浮肿性肿瘤，伴有右侧硬膜外积脓和眶周蜂窝织炎。一个多学科团队参与了该患者的治疗。开始静脉使用抗生素，并首先通过额窦皮肤进行经皮引流，随后进行内镜鼻窦引流。3天后进行了剖宫产。六周后影像学检查显示鼻窦和颅内积液完全消退。
本病例凸显了妊娠期间鼻窦炎罕见颅内并发症管理的挑战以及多学科护理的重要性。
