Evidence map›Paper›PMID 40782155›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

Management of pott's puffy tumor: a Delphi-method international clinical consensus statement.

Nicolien van der Poel, Gopi Shah, Nikolaus Wolter, Christos Georgalas, Anneclaire Vroegop, Vincent Couloigner, Francois Simon, Amanda L Stapleton, Dana Crosby, Uma Ramaswamy and 13 more

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Occupational human papillomavirus exposure risks for laryngeal surgeons and phoniatricians: A joint European Laryngological Society (ELS) and Union of European Phoniatricians (UEP) Delphi clinical consensus statement.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Nicolien van der PoelDepartment of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium.
Gopi ShahPediatric otolaryngologist at ENT Surgery Solutions, Evansville, IN, USA.
Nikolaus WolterDepartment of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Christos GeorgalasDepartment of Head, Neck and Skull Base Surgery, Hygeia Hospital, Athens, Greece.
Anneclaire VroegopDepartment of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium.
Vincent CouloignerDepartment of Pediatric Otolaryngology, AP-HP, Hôpital Necker Enfants Malades, Paris, France.
Francois SimonDepartment of Pediatric Otolaryngology, AP-HP, Hôpital Necker Enfants Malades, Paris, France.
Amanda L StapletonDepartment of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
Dana CrosbyDepartment of Otolaryngology Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
Uma RamaswamyDepartment of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA.
Patrick WalzDepartment of Pediatric Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
Randa Al-BaraziDepartment of Otolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Peter-John WormaldDepartment of Surgery-Otorhinolaryngology Head and Neck Surgery, Central Adelaide Local Health Network, University of Adelaide, Adelaide, SA, Australia.
Enrique OrtizAntiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Perla VillamorEar, Nose and Throat Department, American Hospital, Dubai, United Arab Emirates.
Jin-Young MinDepartment of Otorhinolaryngology-Head & Neck Surgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Alvaro PachecoClínica Universidad de Los Andes, Santiago, Chile.
Cristobal LangdonDepartment of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain.
Paresh NaikDepartment of Otorhinolaryngology, Jaslok Hospital & Research Centre, Mumbai, India.
Shazia PeerDepartment of Otolaryngology, University of Cape Town, Cape Town, South Africa.
Rania MehannaDepartment of Otolaryngology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
John R CraigDepartment of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, MI, USA.
Alberto Maria SaibeneOtolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo Hospital, Università Degli Studi di Milano, Milan, Italy. alberto.saibene@unimi.it.ORCID http://orcid.org/0000-0003-1457-6871

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePott's puffy tumor (PPT) is a rare and complex condition that requires a comprehensive diagnostic approach and multi-faceted treatment strategy. It is associated with a significant risk of intracranial complications. The purpose of this clinical consensus statement (CCS) is to systematically assess diagnostic and therapeutic approaches of patients with PPT, using the best available evidence and expertise of the panel. The results and recommendations are intended to support clinicians in making informed decisions when managing patients with PPT and to standardize diagnostic, antibiotic, and surgical management across institutions. This consensus also aimed to provide a basis for a subsequent international prospective registry to inform data-driven care.

methodsA literature review was performed via PubMed, and an international panel of 23 experts judged 33 statements in two rounds using a modified Delphi method survey to establish expert recommendations on the diagnostic considerations, medical and surgical management, and postoperative considerations. Strong consensus was defined by a mean score of ≥ 8.00 with no outliers, and consensus by a mean score of ≥ 7.00 with no more than 1 outlier.

resultsA strong consensus was reached on important aspects of the diagnosis and treatment of patients with PPT. Most pivotal are the importance of urgent imaging, imaging of the brain with a preference of MRI, the importance of broad spectrum intravenous antibiotic treatment, and the goal of surgery - resolution of the periosteal abscess and clearance of the frontal sinus drainage pathway - which can be established in various ways and is case and surgeon dependent.

conclusionIn patients with PPT, a high index of suspicion of intracranial complications is important to prevent any delay in treatment initiation. The recommendations formulated in this international consensus statement aim to improve the diagnosis and care for patients with PPT and to address gaps and uncertainties in current guidelines. Items that did not reach consensus may serve as areas for further research.

Indexed as

Pott Puffy TumorAnti-Bacterial AgentsDelphi TechniqueDrainageHumansMagnetic Resonance ImagingAnti-Bacterial AgentsAcute sinusitisClinical guidelineDelphi consensusExpert consensusIntracranial abscessPediatric otolaryngologyPott’s puffy tumor

Identifiers

PMID40782155
PMCPMC12423165

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.