Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Pott's puffy tumor of the upper eyelid misdiagnosed as simple abscess: a case report and literature review

  • Kuylhee Kim (Department of Plastic and Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital) ;
  • Donghyun Lee (Department of Plastic and Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital) ;
  • Soyeon Jung (Department of Plastic and Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital) ;
  • Chul Hoon Chung (Department of Plastic and Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital) ;
  • Yongjoon Chang (Department of Plastic and Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital)
  • Received : 2023.09.21
  • Accepted : 2024.02.13
  • Published : 2024.06.20
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Abstract

A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis. First, surgical incision and drainage were performed in our department, and a percutaneous vacuum drain was placed. To provide a more definitive treatment, endoscopic sinus surgery (ESS) was subsequently performed by otorhinolaryngologists. The patient was discharged without any complications 5 days after ESS. At a 1-year follow-up, no recurrence or notable neurological symptoms were observed. In the case we observed, the patient presented with an upper eyelid abscess and cellulitis, indicating possible orbital involvement. For such patients, a CT scan is necessary. Given the possibility of PPT, it is critical to perform a comprehensive differential diagnosis rather than defaulting to a straightforward approach involving abscess treatment.

Keywords

References

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