RESUMO
We encountered a case involving a brain abscess in the right frontal lobe of a 12-year-old girl who was diagnosed with a chief complaint of headache and nausea. Left maxillary sinusitis, a dental infection related to dental caries and apical periodontitis, was observed in the left maxillary first molar in addition to left frontal sinusitis also being present. In addition to administering antibacterial agents, extraction of the left maxillary first molar and drainage of the paranasal sinuses and brain abscess were performed. Follow-up over the course of 1 year and 5 months indicated that the patient had progressed without any sequelae; therefore, the prognosis was good. In this case, although bone destruction was observed in the posterior wall of the frontal sinus, which could be a route for bacteria to enter the skull, we considered the possibility of direct invasion from the same site to be low because the brain abscess occurred on the opposite side. We believe that a route for hematogenous invasion from apical periodontitis, in addition to sinusitis, is also possible. Regardless of the route, the outset was an infection in the dental field; therefore, this case reaffirmed the importance of dental cavity treatment in childhood.
Assuntos
Antibacterianos , Abscesso Encefálico , Sinusite Frontal , Sinusite Maxilar , Humanos , Feminino , Abscesso Encefálico/etiologia , Abscesso Encefálico/microbiologia , Criança , Sinusite Maxilar/etiologia , Sinusite Maxilar/microbiologia , Antibacterianos/administração & dosagem , Sinusite Frontal/complicações , Sinusite Frontal/microbiologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Drenagem/métodos , Cárie Dentária/etiologia , Cárie Dentária/microbiologia , Cárie Dentária/terapia , Resultado do Tratamento , Extração Dentária/efeitos adversos , Tomografia Computadorizada por Raios X , Periodontite Periapical/etiologia , Periodontite Periapical/microbiologia , Periodontite Periapical/terapia , Dente MolarAssuntos
Aspergilose , Humanos , Aspergilose/epidemiologia , Aspergilose/microbiologia , Masculino , Feminino , Pessoa de Meia-Idade , Prevalência , Sinusite Frontal/microbiologia , Adulto , Idoso , Seio Frontal/microbiologia , Seio Frontal/patologia , Tomografia Computadorizada por Raios X , Estudos RetrospectivosRESUMO
Pott's puffy tumour (PPT) is a known complication of frontal sinusitis. It is defined as subperiosteal abscess formation due to osteomyelitis of the frontal bone presenting as a forehead swelling. It is a life-threatening condition that can lead to intracranial and intraorbital complications. Gadolinium-enhanced MRI and contrast CT scan are the best modalities to localise and define the collection, in addition to confirming disease extension. Once confirmed by imaging and depending on disease extension, management of PPT requires a multidisciplinary team approach and depends on the local provision of surgical care. Following surgical drainage of the abscess cavity, a prolonged course of antibiotics is required postoperatively to treat the underlying osteomyelitis.
Assuntos
Abscesso/tratamento farmacológico , Osso Frontal/patologia , Tumor de Pott/complicações , Abscesso/cirurgia , Administração Intravenosa , Adolescente , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Sinusite Frontal/diagnóstico por imagem , Sinusite Frontal/microbiologia , Sinusite Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Celulite Orbitária/etiologia , Celulite Orbitária/patologia , Osteomielite/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND AND AIM OF THE WORK: Fungal rhinosinusitis (FRS) is a clinical entity characterized by the presence of fungi within sino-nasal cavities that may occur in patients with normal or defective immunity. Allergic fungal rhinosinusitis (AFRS) is a form of non-invasive FRS that affects patients with an abnormal immuno-mediated response to fungal antigens. This article describes a case of isolated fronto-ethmoidal AFRS. METHODS: A 20-year old male patient presented with a history of a left nasal respiratory obstruction and allergic oculorhinitis. CT scans showed a polypoid mass in the left nasal cavity and opacification of the left ethmoid sinus, frontal recess and frontal sinus with hyperdense component. The patient underwent functional endonasal sinus surgery (FESS) with removal of nasal polyps from the left nasal cavity and of cheesy-like material and dense mucus from the left ethmoid and frontal sinus. Histological examination showed presence of fungal hyphae within the allergic mucus; a diagnosis of AFRS was made. RESULTS: Follow up at 14 months showed no signs of recurrence. CONCLUSIONS: The AFRS case reported herein is characterized by isolated unilateral fronto-ethmoid involvement, a rare presentation. Endoscopic nasal treatment was effective with complete patient recovery. (www.actabiomedica.it).
Assuntos
Sinusite Etmoidal/microbiologia , Sinusite Frontal/microbiologia , Micoses , Rinite Alérgica/microbiologia , Sinusite Etmoidal/diagnóstico , Sinusite Etmoidal/cirurgia , Sinusite Frontal/diagnóstico , Sinusite Frontal/cirurgia , Humanos , Masculino , Micoses/diagnóstico , Micoses/cirurgia , Rinite Alérgica/diagnóstico , Rinite Alérgica/cirurgia , Adulto JovemRESUMO
BACKGROUND: Sino-nasal aspergillosis is a common nasal disease in dogs. Recommended treatment protocols typically involve trephination of the frontal sinuses or the use of an antifungal solution instilled into the frontal sinus under anesthesia, both of which have associated morbidity and complications. OBJECTIVES: To assess a minimally-invasive topical treatment protocol for sino-nasal aspergillosis in dogs. ANIMALS: Twelve client-owned dogs diagnosed with sino-nasal aspergillosis that completed recommended treatment. METHODS: Medical records were retrospectively reviewed to identify dogs with sino-nasal aspergillosis that received treatment. Fungal plaques were manually debrided and irrigated via frontal sinuscopy in 12 dogs that then were treated topically with 1% topical clotrimazole cream. Irrigation and topical medication application was achieved using a catheter placed retrograde directly into the frontal sinuses using the Seldinger technique over a guidewire, thereby avoiding the need for frontal sinus trephination. Invasion into the calvarium was recorded before treatment but was not considered a criterion for exclusion. Debridement and cream deposition was repeated every 2 weeks as needed until negative culture and histopathologic findings were obtained. RESULTS: All dogs were cured (negative results for Aspergillus on endoscopy, fungal culture, and histopathology) with a median of 2 treatments. Treatments were well tolerated, with minimal adverse effects reported. Three dogs had evidence of erosion into the calvarium on computed tomography imaging. CONCLUSIONS AND CLINICAL IMPORTANCE: This protocol appears to be an effective and well-tolerated minimally invasive treatment for sino-nasal aspergillosis, including in dogs with erosion into the calvarium. Only mild adverse effects were noted.
Assuntos
Antifúngicos/uso terapêutico , Aspergilose/veterinária , Doenças do Cão/microbiologia , Doenças Nasais/veterinária , Administração Intranasal/veterinária , Animais , Antifúngicos/administração & dosagem , Aspergilose/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Cães , Feminino , Sinusite Frontal/tratamento farmacológico , Sinusite Frontal/microbiologia , Sinusite Frontal/veterinária , Masculino , Doenças Nasais/tratamento farmacológico , Doenças Nasais/microbiologia , Estudos RetrospectivosRESUMO
The authors present the case of a 19-year old man presenting to the emergency department with a 2-day history of left eye pain and ptosis, facial pain around the maxillae, coryza, headaches and fevers. He had a background of autism, mild learning disability, obsessive-compulsive disorder and asthma. Within the last month, his risperidone and sertraline doses had been increased. Basic observations and investigations suggested sepsis: tachypnoea, sinus tachycardia, fever and a raised white cell count and C reactive protein level. A CT head showed sinonasal polyposis and moderate chronic rhinosinusitis, with normal intracranial appearances. An MRI head showed evidence of extension of frontal sinus infection through the posterior wall of the left frontal sinus with subsequent left frontal extradural empyema. Intravenous antibiotics and surgical drainage of the left frontal sinus resulted in clinical improvement and discharge to complete the course of antibiotics in the community.
Assuntos
Blefaroptose/diagnóstico , Seio Frontal/diagnóstico por imagem , Sinusite Frontal/microbiologia , Cabeça/diagnóstico por imagem , Sepse/diagnóstico , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Blefaroptose/etiologia , Drenagem/métodos , Empiema/tratamento farmacológico , Empiema/microbiologia , Abscesso Epidural/tratamento farmacológico , Abscesso Epidural/microbiologia , Dor Ocular/diagnóstico , Dor Facial/diagnóstico , Febre/diagnóstico , Seio Frontal/patologia , Seio Frontal/cirurgia , Sinusite Frontal/tratamento farmacológico , Sinusite Frontal/cirurgia , Cabeça/microbiologia , Cefaleia/diagnóstico , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Sepse/etiologia , Resultado do Tratamento , Adulto JovemRESUMO
A case is presented in which pre-autopsy postmortem computed tomography (PMCT) revealed an unexpected brain abscess with a related frontal sinusitis and an erosion of the posterior wall of the frontal sinus. PMCT findings enabled the forensic pathologists to adapt protective measures during autopsy and protect their health from infection. Pre-autopsy PMCT has been also useful in the early differential diagnosis procedure. The complementary use of postmortem imaging and autopsy can improve the quality of forensic death investigations.
Assuntos
Autopsia/métodos , Abscesso Encefálico/diagnóstico por imagem , Sinusite Frontal/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Abscesso Encefálico/microbiologia , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/microbiologia , Patologia Legal , Sinusite Frontal/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/diagnóstico , Imagem Corporal TotalRESUMO
Fungus ball (FB) is an non-invasive form of mycosis, that generally affects immunocompetent and non-atopic subjects. Involvement of the frontal sinus is extremely rare. We report two cases with frontal sinus fungus ball that underwent endoscopic endonasal frontal Draf type IIb or III sinusotomy with complete removal of the cheesy clay-like material. There were no intra-operative or postoperative complications, and no recurrence of disease was evident during the follow-up of 51 and 26 months, respectively. The Draf type IIb or type III frontal sinusotomy seems to be highly effective for the treatment of frontal sinus FB and can represent a valid alternative to the traditional external approaches.
Assuntos
Aspergillus fumigatus/isolamento & purificação , Seio Frontal , Sinusite Frontal , Micoses , Procedimentos Cirúrgicos Nasais/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Idoso , Seio Frontal/diagnóstico por imagem , Seio Frontal/microbiologia , Seio Frontal/cirurgia , Sinusite Frontal/diagnóstico , Sinusite Frontal/microbiologia , Sinusite Frontal/fisiopatologia , Sinusite Frontal/cirurgia , Humanos , Itália , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/fisiopatologia , Micoses/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Sinusite Frontal/diagnóstico , Hospedeiro Imunocomprometido , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium chelonae/isolamento & purificação , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Drenagem/métodos , Sinusite Frontal/microbiologia , Sinusite Frontal/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/terapia , Cirurgia Endoscópica por Orifício Natural/métodos , Nariz , Tomografia Computadorizada por Raios XRESUMO
AIM: To analyze the indications and outcomes of open neurosurgical approaches (ONA) and endoscopic transnasal approaches (ETA) in the surgical management of pediatric sinogenic subdural and epidural empyema. MATERIAL AND METHODS: Retrospective single-center study design within a tertiary care referral center setting. Children less than 18 years of age consecutively operated on between January 2012 and February 2014 for drainage of a sinogenic subdural empyema (SE) or epidural (EE) empyema were included. MAIN OUTCOME MEASURES: success of first surgical procedure, persistent symptoms and sequelae at the end of the follow-up period. RESULTS: Nine SE (53%) and 8 EE (47%) were observed. Neurological symptoms, especially seizures, were more frequent in the SE group. Perioperative pus samples were positive in 67% of the SE group and in 75% of the EE group. The most frequently isolated bacteria belonged to the Streptococcus anginosus group. CT or MR imaging showed that most empyema probably originated from the frontal sinus. However, two cases resulted from an ethmoiditis and one case from a Pott's puffy tumor, without any direct contact with the paranasal sinus. In cases of SE, the most effective surgical technique was ONA with craniotomy. Associated endoscopic sinus drainage was useful for the purpose of bacteriological diagnosis. In cases of EE, effectiveness was noted in both ONA and ETA techniques. In two cases of EE, the ETA procedure encompassed direct drainage of the empyema through the posterior wall of the frontal sinus (Draf III approach). The number of patients successfully treated after a single surgical procedure was higher in the EE group (p=0.05). Regarding outcomes, no mortalities were observed. Persistent disorders at the end of the follow-up period, especially headaches, cognitive, concentration or schooling problems, tended to be more frequent in the SE group than in the EE group (67% vs 29%), and were more commonly observed in cases requiring several surgical procedures (75% vs 12.5%) (p=0.05). DISCUSSION: Endoscopic sinus surgery plays a critical role in the surgical management of pediatric sinogenic SE and EE. In cases of small volume EE, the endoscopic approach associated with antibiotherapy may be sufficient to treat the infectious process.
Assuntos
Empiema Subdural/cirurgia , Endoscopia , Abscesso Epidural/cirurgia , Infecções Estreptocócicas/complicações , Streptococcus anginosus , Adolescente , Criança , Transtornos Cognitivos/etiologia , Craniotomia/efeitos adversos , Drenagem , Empiema Subdural/complicações , Empiema Subdural/microbiologia , Endoscopia/efeitos adversos , Endoscopia/métodos , Abscesso Epidural/complicações , Abscesso Epidural/microbiologia , Sinusite Etmoidal/diagnóstico por imagem , Sinusite Etmoidal/microbiologia , Feminino , Sinusite Frontal/diagnóstico por imagem , Sinusite Frontal/microbiologia , Cefaleia/etiologia , Humanos , Deficiências da Aprendizagem/etiologia , Masculino , Nariz , Radiografia , Estudos RetrospectivosRESUMO
We describe the clinical presentation, radiographic findings, management, and outcome of a subdural empyema in a 14-year-old male with history of recent partially treated acute sinusitis. Subdural empyema is a rare but life threatening complication, usually following paranasal sinusitis, otitis media, mastoiditis, cranial surgery, a skull fracture, or from distant spread from sites such as a pulmonary infection. The initial evaluation should include a thorough history and physical examination, complete blood count, electrolytes, C-reactive protein, erythrocyte sedimentation rate, chest x-ray, urinalysis, and neuroimaging of the brain with intravenous contrast. If a subdural empyema is identified, then intravenous antibiotics should be initiated, and immediate neurosurgical consultation should be obtained to consider operative drainage.
Assuntos
Erros de Diagnóstico , Empiema Subdural/diagnóstico , Sinusite Frontal/complicações , Infecções por Bactérias Gram-Positivas/diagnóstico , Cefaleia/etiologia , Peptostreptococcus/isolamento & purificação , Tomografia Computadorizada por Raios X , Adolescente , Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Transtornos da Consciência/etiologia , Serviço Hospitalar de Emergência , Empiema Subdural/complicações , Empiema Subdural/microbiologia , Empiema Subdural/terapia , Febre/etiologia , Sinusite Frontal/diagnóstico por imagem , Sinusite Frontal/microbiologia , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/terapia , Hematoma Subdural/diagnóstico , Humanos , Masculino , Transtornos de Enxaqueca/diagnósticoRESUMO
BACKGROUND: Frontal sinus involvement in aspergillosis associated with the nose and paranasal sinuses is a common occurrence, but the incidence of primary frontal sinus aspergillosis is rare, and there are few reports in the English literature. OBJECTIVE: This study aimed to evaluate the role of the endonasal endoscopic surgical approach for isolated primary frontal sinus aspergillosis. METHOD: This paper describes a retrospective study of 16 cases of primary frontal sinus aspergillosis. The patients had presented to the out-patient services of the Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, between January 1999 and July 2011. RESULTS: The overall success rate of the endonasal endoscopic approach was 82.25 per cent. The disease recurred in three patients and was subsequently managed using the modified Lothrop procedure. CONCLUSION: Minimally invasive endonasal endoscopic sinus surgery was found to be an effective and a safe approach for managing primary frontal sinus aspergilloma, even in cases with larger bony defects involving the posterior table of the frontal sinus.
Assuntos
Aspergilose/cirurgia , Endoscopia/métodos , Sinusite Frontal/cirurgia , Adolescente , Adulto , Aspergilose/patologia , Criança , Feminino , Seio Frontal/microbiologia , Seio Frontal/patologia , Seio Frontal/cirurgia , Sinusite Frontal/microbiologia , Sinusite Frontal/patologia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Seios Paranasais/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To use computed tomography (CT) to assess the distribution of surgically administered clotrimazole cream and associated filling of the frontal sinuses and caudal aspect of the nasal cavities in canine cadavers. STUDY DESIGN: Observational study. ANIMALS: Small (n = 1) and medium-large (n = 11) breed canine cadavers. METHODS: CT scans of 12 cadaveric canine heads were used to confirm absence of sinonasal disease. Then after creating an opening into the left and right frontal sinuses with a 3.2 mm Steinmann pin at standardized landmarks, clotrimazole cream (20 g) was instilled into each side. Postoperative CT scans of the heads was used to assess the distribution and degree of filling of the sinonasal cavities with clotrimazole cream, and to identify any damage to local structures. RESULTS: Filling was excellent in 22 sinuses, very poor in 2, and excellent in all caudal nasal cavities. Two cadavers had damage: unilateral penetration of the cranium (2) and unilateral penetration of the lateral sinus wall (1). CONCLUSION: Excellent filling of most of the frontal sinuses and caudal nasal cavity of cadavers with clotrimazole cream is achieved when administered by this technique. Damage to local structures may occur intraoperatively using this technique.
Assuntos
Antifúngicos/administração & dosagem , Clotrimazol/administração & dosagem , Seio Frontal/cirurgia , Administração Intranasal , Animais , Aspergilose/tratamento farmacológico , Aspergilose/cirurgia , Aspergilose/veterinária , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Feminino , Seio Frontal/diagnóstico por imagem , Seio Frontal/microbiologia , Sinusite Frontal/tratamento farmacológico , Sinusite Frontal/microbiologia , Sinusite Frontal/cirurgia , Sinusite Frontal/veterinária , Masculino , Tomografia Computadorizada por Raios X/veterináriaAssuntos
Abscesso Encefálico/microbiologia , Diabetes Mellitus/patologia , Sinusite Frontal/microbiologia , Schizophyllum/isolamento & purificação , Anfotericina B/farmacologia , Anfotericina B/uso terapêutico , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Encéfalo/diagnóstico por imagem , Encéfalo/microbiologia , Abscesso Encefálico/tratamento farmacológico , DNA Fúngico/genética , Sinusite Frontal/cirurgia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/tratamento farmacológico , Micoses/microbiologia , Radiografia , Schizophyllum/efeitos dos fármacos , Schizophyllum/genéticaRESUMO
The clinical presentation and course of orbital cellulitis in a young adult resulting from Arcanobacterium hemolyticum frontal sinusitis are presented in detail. This case illustrates the importance of a multidisciplinary approach for refractory and aggressive orbital cellulitis. A high level of suspicion for A. hemolyticum must be maintained in such cases, because it has proven to be a rare but aggressive, potentially occult, and life-threatening pathogen.
Assuntos
Abscesso/microbiologia , Infecções por Actinomycetales/microbiologia , Arcanobacterium/isolamento & purificação , Infecções Oculares Bacterianas/microbiologia , Celulite Orbitária/microbiologia , Abscesso/diagnóstico , Abscesso/terapia , Infecções por Actinomycetales/diagnóstico , Infecções por Actinomycetales/terapia , Antibacterianos/uso terapêutico , Terapia Combinada , Drenagem , Quimioterapia Combinada , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/terapia , Sinusite Frontal/diagnóstico , Sinusite Frontal/microbiologia , Sinusite Frontal/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes de Sensibilidade Microbiana , Celulite Orbitária/diagnóstico , Celulite Orbitária/terapia , Tomografia Computadorizada por Raios X , Acuidade Visual , Adulto JovemRESUMO
The objective of the study is to estimate the efficacy of Bioparox (fusafungine) when used for the treatment of the adult patients presenting with acute frontitis. Twenty two of the 45 patients with this condition were given adjuvant therapy using this preparation. It resulted in a decrease of the concentration of Staphylococcus aureus and S. epidermidis to 10 CFU/ml and 500 CFU/ml respectively. S. haemoliticus was completely eradicated. The concentrations of these microorganisms in patients of the control group were higher. The level of interleukin 1-beta in the secretion within 5 days after the onset of therapy was twice lower than in the patients of control group. The concentration of IL 1-beta in the serum of the treated with Bioparox patients was 4 pg/ml compared with 8 pg/ml in the control group. The efficacy of therapy of acute frontitis with fusafungine was confirmed in the X-ray study. It is concluded that the use of Bioparox for the management of acute frontitis increases the efficacy of the treatment and result in the marked improvement of the patients' condition within 5 days after the onset of therapy.
Assuntos
Bactérias/efeitos dos fármacos , Sinusite Frontal , Interleucina-1beta/metabolismo , Doença Aguda , Administração Tópica , Adulto , Antibacterianos/administração & dosagem , Bactérias/classificação , Bactérias/isolamento & purificação , Contagem de Colônia Microbiana/métodos , Depsipeptídeos , Monitoramento de Medicamentos , Feminino , Seio Frontal/diagnóstico por imagem , Seio Frontal/microbiologia , Sinusite Frontal/diagnóstico , Sinusite Frontal/tratamento farmacológico , Sinusite Frontal/metabolismo , Sinusite Frontal/microbiologia , Fusarium , Humanos , Longevidade , Masculino , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Testa/diagnóstico por imagem , Sinusite Frontal/diagnóstico por imagem , Tumor de Pott/diagnóstico por imagem , Tumor de Pott/microbiologia , Infecções Estafilocócicas/diagnóstico , Antibacterianos/uso terapêutico , Feminino , Testa/microbiologia , Osso Frontal/patologia , Sinusite Frontal/microbiologia , Humanos , Pessoa de Meia-Idade , Tumor de Pott/tratamento farmacológico , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important.
Assuntos
Abscesso Encefálico/microbiologia , Assistência Odontológica/efeitos adversos , Sinusite Frontal/complicações , Sinusite Maxilar/complicações , Fístula Bucoantral/etiologia , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Adolescente , Antibacterianos/uso terapêutico , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/cirurgia , Drenagem , Diagnóstico Precoce , Sinusite Frontal/diagnóstico , Sinusite Frontal/tratamento farmacológico , Sinusite Frontal/microbiologia , Sinusite Frontal/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/tratamento farmacológico , Sinusite Maxilar/microbiologia , Sinusite Maxilar/cirurgia , Fístula Bucoantral/complicações , Fístula Bucoantral/diagnóstico , Fístula Bucoantral/tratamento farmacológico , Fístula Bucoantral/cirurgia , Staphylococcus aureus/isolamento & purificação , Resultado do TratamentoRESUMO
Pott puffy tumor is defined as a forehead-localized swelling with overlying subperiosteal abscess and osteomyelitis of the frontal bone. It is an uncommon disease entity and more rarely reported with its frontocutaneous fistula. We report the unusual case of Pott puffy tumor appearing with a frontocutaneous fistula. We performed a frontal sinus surgery using a combined endonasal and percutaneous approach and frontal bone reconstruction with a resorbable mesh plate and bone cement. During a follow-up 1 year after the surgery, there was no recurrence, and we achieved excellent result from the aesthetic point of view.