Complications of rhinosinusitis
BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i795 (Published 26 February 2016) Cite this as: BMJ 2016;352:i795
- Stephen L Ball, specialty registrar and Wellcome Trust clinical research fellow1,
- Sean Carrie, consultant ear, nose, and throat surgeon1
- 1Ear, Nose, and Throat Surgery, Freeman Hospital, Newcastle upon Tyne, UK
- Correspondence to: S L Ball s.l.ball{at}ncl.ac.uk
A 65 year old man was initially referred to plastic surgery because of a recurrent abscess on the forehead, and headache. He was subsequently referred to ear, nose, and throat surgery for definitive management of his sinus complication. What is the diagnosis?
Answer
A subperiosteal abscess secondary to frontal sinusitis and osteomyelitis (Pott’s puffy tumour) that has spontaneously burst.
Discussion
Frontal sinusitis with osteomyelitis (Pott’s puffy tumour) may present with headache, swelling, and sometimes a discharging frontal sinus fistula (fig 2⇓). It arises as a complication of frontal sinusitis and can spread intracranially, with complications from erosion of the posterior table, or more likely by septic thrombophlebitis through …
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