The Journal of Laryngology & Otology June 2001, Vol. 115, pp. 497–499 Pott’s puffy tumour: an unusual presentation and management A. A. Maheshwar, F.R.C.S., D.L.O., D. A. Harris, M.B.B.Ch., N. Al-Mokhthar, F.R.C.R. * , R. A. Evans, F.R.C.S. Abstract Pott’s puffy tumour is a rare clinical entity in this era of antibiotics. It is usually seen as a complication of frontal sinusitis. This is the rst report of Pott’s puffy tumour presenting as a complication of maxillary sinusitis. This is also the rst reported case of Pott’s puffy tumour treated with debridement and gentamicin beads. We discuss the clinical presentation and successful treatment of this rare disease. Key words: Frontal Sinus; Osteomyelitis; Gentamicins Case report A 14-year-old boy was referred to our department in August 1999 with pain and swelling around the left frontal sinus for a week, which had worsened over the last 24 hours despite oral ucloxacillin. The patient had no symptoms suggestive of intracranial complications. On examination he had a low grade pyrexia with peri-orbital oedema and was tender in the left supra-orbital region. He had normal visual acuity and ocular movement. X-ray of the sinuses showed left pan-sinusitis. Blood cultures showed no growth. He was treated with intravenous co- amoxiclav and nasal decongestants. He was discharged home, when the sinusitis was clinically resolved, three days later. He was advised to continue with the antibiotics, orally for a week. He was readmitted two weeks later with similar symptoms and signs. His general practitioner had started him on cephradine. Rpeat sinus X-ray however showed an opaque left maxillary sinus with air uid level (Figure 1). He was started on intravenous co-amoxiclav. We per- formed bilateral intranasal antrostomies, antral wash-outs and reduction of turbinates. Pus was cleared from the left From the Departments of Otolaryngology and Radiology * , Princess of Wales Hospital, Bridgend, UK. Accepted for publication: 5 January 2001. Fig. 1 Sinus X-ray. Fig. 2 CT scan of head and sinuses. 497