Cranial tonsillotomy for peritonsillar abscess: what a relief!

Windfuhr, Jochen P.; Nematian, M; Ziogou, S

doi:10.1007/s00405-016-4158-3

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…only a partial resection of the tonsils should be discussed and considered more seriously as an alternative to tonsillectomy in the case of RAT, as tonsillotomy should preserve, at least partially, tonsil immunity. In the case of PTA, abscess incision or cranial tonsillotomy 24 as an alternative to abscess tonsillectomy could similarly be a promising strategy from an immunological perspective.…”

Section: Discussionmentioning

confidence: 99%

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

Geißler

Weigel

Schubert

et al. 2020

Sci Rep

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the aim of this study was to examine t cell function in tonsils of patients with recurrent acute tonsillitis (RAT) or peritonsillar abscess (PTA) by analyzing the cytokine production following T cell receptor (TCR) and co-receptor stimulation with a combination of anti-CD3 and anti-CD28 antibodies. The release of IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 and IL-17A from isolated, stimulated T cells of 27 palatine tonsils (10 RAT, 7 PTA, 10 tonsils without inflammation) was measured via a bead-based flow cytometric analysis. The results were compared with the cytokine release of isolated peripheral T cells in a subset of the same patients (6 PTA, 4 patients without signs of inflammation in the blood). tcR stimulation increased the concentration of released cytokines in tonsil and blood as well as in different forms of inflammation and tissue with no inflammation. Stimulation increased the proinflammatory cytokines TNF-α, IFN-γ, and IL-2 more than the anti-inflammatory cytokines IL-4 and IL-10 in tonsil and blood samples in RAT, PTA, and samples without inflammation. Blood of patients with PTA showed a higher pro-inflammatory cytokine level compared to the samples of patients without inflammation. T cells in tonsils are fully responsive and competent for antigen-induced cytokine production in RAT and PTA. One should be aware that tonsillectomy, if indicated, might remove a functioning immune organ. Tonsillotomy might be an alternative even in adults to maintain immunological function. The palatine tonsils as paired lymphatic organs are located at the beginning of the upper aerodigestive tract and are responsible for immune protection against ingested and inhaled pathogens. In this context, innate and adaptive immune reactions interact, whereby tonsillar T cells located primarily in the extra-follicular spaces, in particular, play a dominant role 1. Cytokines are produced in the context of inflammatory reactions by immunecompetent cells. A distinction is made between genuine pro-inflammatory, e. g. tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-6, IL17-A, and mostly anti-inflammatory cytokines like IL-4 and IL-10 2-4. Furthermore, depending on the inflammatory scenario, T-cells can differentiate into differently primed states, including Th1, Th2, and Th17. Briefly, Th1 helper cells produce large amounts of IFN-γ, IL-2, and TNF-β, which trigger macrophages and are important for cell-mediated immunity and phagocyte-dependent immune responses. Th2 cells produce IL-4, IL-5, IL-10, and IL-13, which promote antibody production, eosinophil activation, and inhibition of several macrophage functions 5. Th17 cells and their effector cytokines IL-17A, IL-17F, IL-21, and IL-22 mediate host defense mechanisms to a variety of infections, especially of bacterial origin, and are furthermore involved in the pathogenesis of many autoimmune diseases 6. Recurrent acute tonsillitis (RAT) is a common chronic inflammation of the palatine tonsils, which often needs surgical excision 7 .

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Section: Discussionmentioning

confidence: 99%

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

Geißler

Weigel

Schubert

et al. 2020

Sci Rep

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“…Standard treatment is surgical drainage by needle or knife in the supratonsillar fold, alongside medical and antimicrobial therapy. 2 Drainage is performed by a solo practitioner. This treatment provides immediate relief for patients and prevents complications; hence, prompt and safe surgical treatment is a priority.…”

Section: Introductionmentioning

confidence: 99%

The Newport Quinsy Simulator

2022

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Background The junior otolaryngologist is responsible for recognition and drainage of the peritonsillar abscess. Although other simulators have been proposed, there is still a need for an accessible, educationally useful, low-cost peritonsillar abscess simulator to build skills and confidence in the novice. Methods The peritonsillar abscess simulator was constructed from basic disposable healthcare equipment and a party balloon. Evaluation of this Newport Quinsy Simulator was performed by expert and novice clinicians, who provided feedback in the form of Likert scales and free-text qualitative responses. Results Overall, 24 clinicians evaluated the simulator. All felt the simulator was useful for the novice otolaryngologist, and represented the key anatomy and motor skills needed to drain a peritonsillar abscess. Qualitative evaluation highlighted the educational usefulness of the simulator as a peritonsillar abscess training device. Conclusion The Newport Quinsy Simulator is affordable, accessible, easy to use and educationally valuable to the novice otolaryngologist.

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Cranial tonsillotomy for peritonsillar abscess: what a relief!

Cited by 2 publications

References 44 publications

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

Cytokine production in patients with recurrent acute tonsillitis: analysis of tonsil samples and blood

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