title: Orbital involvement in Pott's puffy tumor: a systematic review of published cases.
abstract: BACKGROUND
  Pott's puffy tumor (PPT) is a frontal subperiosteal abscess associated with underlying frontal bone osteomyelitis. It represents a well-known source of sinogenic intracranial infection, but the orbital complications related to this entity are rarely reported.  The goal of this study was to characterize the orbital involvement in PPT.
  
  
  METHODS
  We performed a systematic review through a Medline search (1950-2010). The authors reviewed all cases of PPT, selecting those explicitly describing orbital complications associated  with PPT.
  
  
  RESULTS
  We screened 139 articles, of which 93 reported cases of PPT. Of these, 35 articles described a total of 42 cases presenting simultaneous orbital complications. Eyelid and/or periorbital edema was the most common finding in patients with orbital involvement,  and preseptal cellulitis is by far the most prevalent orbital complication in PPT. Postseptal involvement (orbital cellulitis, subperiosteal abscess of the orbit, and orbital abscess) is much rarer. Although treatment of the classic PPT is surgical, only a minority of patients with orbital  infection required orbital drainage. Most reported patients made a full recovery, without permanent sequelae.
  
  
  CONCLUSIONS
  Orbital infections are possible in patients with PPT. In contrast to surgical treatment of the frontal subperiosteal abscess, the orbital complications  can be treated conservatively most of the time. Early diagnosis and aggressive therapy of the underling PPT are essential to avoid severe local or systemic complications.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital de Sion, Sion, Switzerland. llnisa@yahoo.ca
authors.forename: Lluís
authors.initials: L
authors.lastname: Nisa
authors.forename: Basile Nicolas
authors.initials: BN
authors.lastname: Landis
authors.forename: Roland
authors.initials: R
authors.lastname: Giger
mesh_terms: D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004487:Edema / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005143:Eyelids / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009916:Orbital Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D059369:Pott Puffy Tumor / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult