Bouchareb N, Adouli A, Abada R L, Rouadi S, Mahtar M, Roubal M, Essaadi M, Kadiri F
CHU Ibn Rochd, Hôpital 20 Aout, Service ORL et Chirurgie Cervico-Faciale, Casablanca, Maroc.
Rev Laryngol Otol Rhinol (Bord). 2012;133(4-5):233-6.
Port's puffy tumour (PPT), corresponding to frontal osteomyelitis causing erosion of the anterior wall of the frontal sinus and subperiosteal abscess, is a rare but serious complication of frontal sinusitis or trauma to the region. It can occur even despite the use of antibiotics and requires surgical drainage of the abscess, excision of pathological tissues and obliteration of the frontal sinus by various materials. It can rarely progress to life-threatening intracranial extension. Practitioners must be extremely cautious in the presence of clinical signs suggestive of Pott's puffy tumour. The aim of this article is to present a case of progressively evolving PPT in a patient of 28 years by frontal headaches that are aggravated by painful swelling front soft and fluctuating by palpation and that has fistulated at the right upper eyelid. CT scan of the face revealed the presence of a discontinuity bone at the anterior wall of the right frontal sinus. The treatment consisted of surgery and antibiotics. The patient remained asymptomatic after a decline of 18 months.
波特氏肿(PPT),对应于导致额窦前壁侵蚀和骨膜下脓肿的额骨骨髓炎,是鼻窦炎或该区域外伤的一种罕见但严重的并发症。即便使用了抗生素,它仍可能发生,需要对脓肿进行手术引流、切除病理组织并用各种材料闭塞额窦。它极少会发展为危及生命的颅内扩展。临床医生在出现提示波特氏肿的体征时必须极其谨慎。本文的目的是呈现一例28岁患者因额部头痛而逐渐发展的PPT病例,头痛因前额软组织疼痛性肿胀而加重,触诊时有波动感,且右上眼睑出现瘘管。面部CT扫描显示右额窦前壁有骨质连续性中断。治疗包括手术和抗生素治疗。18个月病情缓解后,患者保持无症状。