Introduction and objective:

The aim of this study was to provide an updated review of medical and surgical treatment in patients with subperiosteal abscesses, secondary to osteomyelitis of the frontal bone.

Method:

The search was made in PubMed, BVS (virtual health library Spain) and Scopus of the different therapeutic options about Pott's puffy tumor. The review was carried out following the PRISMA criteria.

Results:

Twenty articles were selected in the bibliographic review. 30 patients (24 males, with a mean age of 27 years) were reviewed.The main cause was chronic rhinosinusitis (90%), followed by local trauma. In most cases Draf 2 endoscopic drainage was performed (60%), 5 patients had Draf 3 procedure , three Draf 1 procedure and only one, Draf 2B procedure. One patient was treated by balloon sinuplasty and another by isolated external craniotomy. All patients had either oral or intravenous antibiotics of varying duration. although the therapeutic scheme of vancomycin + ceftriaxoneIV predominates for 6 weeks. There were no further complications following endoscopic surgery. Fistulas healed without requiring surgical debridement or closure.

Discussion:

Pott's puffy tumor is a very rare pathology. Due to the rarity of the pathology, many cases have been underdiagnosed leading to intracranial complications. The external approach has been the treatment for years; it is currently advocated an endonasal approach sometimes guided by neuronavigator; in addition to the corresponding antibiotic therapy for long time.

Conclusions:

Some Pott's puffy tumor cases can be managed endoscopically. The availability of powered angled instruments, high-definition video, and image guidance systems have provided the otolaryngologists with a credible alternative to traditional techniques. Furthermore, improved bioavailability of antibiotics may obviate the need for craniotomy and external drains.

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