Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study

Souza, Dante Lucas Santos; Cabrera, Daniel; Gilani, Waqas I; Campbell, Ronna L.; Carlson, Matthew L.; Lohse, Christine M.; Bellolio, M. Fernanda

doi:10.1002/lary.25960

Cited by 33 publications

(45 citation statements)

References 15 publications

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“…The mean age in this study was 35.4 years. This agrees with the fact that PTA is common among Adolescents and young adults [9,11]. Risberg and colleagues in a retrospective review over three years in Sweden also had similar mean age (31.2 years) [10].…”

Section: Discussionsupporting

confidence: 81%

“…Majority of our patients (72.2%) were females. This is at variance with what is commonly observed [8,9,11]. Other studies reported no significant difference in the prevalence among males or females [10,25].…”

Section: Discussioncontrasting

confidence: 79%

“…This may not be unconnected with the prior use of antibiotics among the patients in this study. Souza and colleagues reported sore throat as their most common symptom [9]. Odynophagia is sometimes used interchangeably with sore throat, though they are distinct entities.…”

Section: Discussionmentioning

confidence: 99%

“…The later can rapidly lead to death if left unattended. Quinsy affects all age groups but peaks in the second and third decades of life [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with PTA may present with sore throat, odynophagia, fever, otalgia, trismus, muffled voice, and halitosis or airway obstruction. Diagnosis is mostly clinical from history and classical examination findings of medialization of the tonsils, contralateral deviation of the uvula, hyperemia of the pharyngeal mucosa, inflamed jugulo-diagastric lymph nodes among others [9,11]. In a few patients, PTA may be bilateral, and the classical features on examination may not be easily identified.…”

Section: Introductionmentioning

confidence: 99%

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Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Aliyu

Yikawe

2019

AJMAH

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Purpose of the Study: Quinsy also known as Peritonsillar abscess (PTA) is a life threatened complication of acute exudative tonsillitis requiring immediate surgical intervention. We profile the clinical presentation and highlight challenges in management. Materials and Methods:A retrospective analysis of all patients diagnosed with Quinsy at the departments of otorhinolaryngology of two-government referral hospital in northwest Nigeria from May 2014 to April 2017. These patients' clinical records were retrieved from the health record department and data extracted were analyzed using Microsoft excel program. Results: A total of 147 adult patients had tonsillitis within the study period. Only eighteen patients with quinsy 13(72.2%) females and 5(27.8%) males with an M: F=1:2.6 were analyzed. Age range is between 18 years -58 years with a mean age of 35.4 years. The highest incidence was 66.7% in patients within the age group 21-40 years. Odynophagia and trismus were the commonest presenting features in all the patients. Side of Quinsy involvement was on the left tonsils Aliyu and Yikawe; AJMAH, 15(3): 1-7, 2019; Article no.AJMAH.49954 2 12(66.7%). There was spontaneous rupture in 5(27.8%) while 13(72.2%) of patients had incision and drainage. All patients had broad-spectrum antibiotics. Interval tonsillectomy was carried out on 12(66.7%) of patients while 6(33.3%) of patients did not consent for tonsillectomy and were subsequently lost to follow up. No recurrence of symptoms or mortality recorded. Conclusion: Quinsy is a life threatening otorhinolaryngological emergency common amongst young female adults. Optimal management is still antibiotics therapy and drainage of abscess in our center. Original Research Article

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

“…The later can rapidly lead to death if left unattended. Quinsy affects all age groups but peaks in the second and third decades of life [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Aliyu

Yikawe

2019

AJMAH

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Utility of Smartphone Telemedical Consultations for Peritonsillar Abscess Diagnosis and Triage

Mallen

Shah

Drake

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCETelemedicine is rapidly gaining traction as a way to reduce costs and connect patients with medical experts outside their local communities. Peritonsillar abscess (PTA) is a logical pathologic condition to evaluate for effectiveness of remote diagnosis given its prevalence and the paucity of on-site otolaryngologists at many institutions.OBJECTIVE To explore the potential of otolaryngology telemedical consultation in triaging and diagnosing patients with suspected PTA. DESIGN, SETTING, AND PARTICIPANTSA comparative effectiveness research study was conducted from January 1 to June 30, 2018, at 3 tertiary care hospitals among 31 consecutive patients aged 18 to 85 years for whom the otolaryngology department was consulted to assess for PTA. Statistical analysis was conducted from July 1 to September 30, 2018.INTERVENTIONS Telemedical evaluation of suspected PTA by 5 attending otolaryngologists blinded to patients' history aside from the chief report of odynophagia. Otolaryngologists rated each patient video on whether they believed the patient had a PTA and whether the case warranted prompt evaluation by an otolaryngologist. Predictions were compared with the criterion standard of drainage or negative needle aspiration. Otolaryngologists additionally assessed video quality. MAIN OUTCOMES AND MEASURESRates of accurate diagnosis and triage of PTA based on otolaryngologists' review of oropharyngeal examinations recorded using standard smartphone cameras, as well as percentage of videos of oropharyngeal examinations using standard smartphone cameras deemed of sufficiently high quality for clinical decisionmaking.RESULTS A total of 31 patients (16 women [51.6%]; mean age, 31.9 years [range, 18-62 years]) were recruited, and 16 patients (51.6%) had a PTA. Comparing otolaryngologists' predictions with PTA status by the criterion standard, the prediction was consistent with that of the criterion standard 81% of the time averaged across otolaryngologists (mean diagnostic accuracy, 0.81). Similarly, the mean diagnostic accuracy was 0.83 when comparing the otolaryngologist's suggestion for a prompt in-person evaluation with actual PTA status by the criterion standard. Comparing patients who were deemed to require prompt otolaryngology evaluation and those with PTA by the criterion standard, mean sensitivity was 90%. Videos were rated as of sufficiently high quality to make a diagnosis in 154 of 155 videos (99.4%). CONCLUSIONS AND RELEVANCEThis study suggests that telemedical consultation is a viable, cost-conscious, efficient, and safe approach to PTA management. Despite having some difficulty diagnosing PTAs based on "history concerning for PTA" and oropharyngeal video alone, otolaryngologists are able to determine, with high sensitivity, which patients require prompt otolaryngology evaluation. The recording of consistently high-quality video using a standard smartphone camera is achievable without formal training.

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Emergency department visits, hospitalizations, and readmissions of patients with a peritonsillar abscess

Johnson

2017

The Laryngoscope

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Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study

Abstract: 4. Laryngoscope, 126:1529-1534, 2016.

Cited by 33 publications

References 15 publications

Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Utility of Smartphone Telemedical Consultations for Peritonsillar Abscess Diagnosis and Triage

Emergency department visits, hospitalizations, and readmissions of patients with a peritonsillar abscess

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