Is Needle Aspiration for Peritonsillar Abscess Still as Good as We Think? A Long-term Follow-up

Shaul, Chanan; Koslowsky, Benjamin; Rodriguez, Mercedes; Schwarz, Yehuda; Muahnna, Nidal; Peleg, Uri; Sichel, Jean‐Yves

doi:10.1177/0003489414556083

Cited by 20 publications

(33 citation statements)

References 22 publications

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“…14,16 In the group of patients analyzed in the study, most patients were young adults aged from 21 to 40 years old who are professionally active people. These data are consistent with those from the literature 2,3,[5][6][7]12 and that makes problem of PTA treatment economically important. The symptoms reported by patients were typical for throat infections.…”

Section: Discussionsupporting

confidence: 92%

“…2 Although, when there is a lack of expected improvement the next step that should be considered is hot tonsillectomy. This procedure is also called tonsillectomy "a chaud" or urgent tonsillectomy and was described at the beginning of 20 th century as typical treatment of PTA.…”

Section: -17mentioning

confidence: 99%

“…The same author recommends hot tonsillectomy in all patients with recurrent PTA, 6,7 as it may prevent recurrences. 2,12 It is still controversial if this tonsillectomy should be performed on one side only or if it should be performed bilaterally. In our material bilateral tonsillectomy was made in all patients who had indications for tonsillectomy, independent from PTA.…”

Section: -17mentioning

confidence: 99%

“…The incidence is estimated to be 30 out of 100,000 people per year. 1,2 Factors predisposing to the development of peritonsillar abscess described in the literature are bad periodontal status and smoking. 2,3 Treatment is always connected with an abscess incision, drainage of purulent content, re-hydration [4][5][6][7][8][9][10] with subsequent antibiotic therapy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Amernik¹,

Sindrewicz²,

Jaworowska³

2016

Otolaryngol Open J

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Section: Discussionsupporting

confidence: 92%

Section: -17mentioning

confidence: 99%

Section: -17mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Amernik¹,

Sindrewicz²,

Jaworowska³

2016

Otolaryngol Open J

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“…To the best of our knowledge, NA is not a standard procedure in University and Academic Teaching Hospitals in Germany. Interestingly, ID is increasingly performed in Germany [12], a method which has been quoted to be equally effective as NA [2,9,14]. However, replacing abscesstonsillectomy by ID resulted in a significant decrease of bleeding complications (0.3 vs. 5.1 %) but also in the need of a painful re-draining of the abscess cavity in approximately 20 % of patients [11].…”

Section: Discussionmentioning

confidence: 99%

Cranial tonsillotomy for peritonsillar abscess: what a relief!

Windfuhr

Nematian

Ziogou

2016

Eur Arch Otorhinolaryngol

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Peritonsillar abscess (PTA) is a common infection of the oropharynx resulting in painful swallowing, sometimes associated with fever, trismus and a typical voice alteration. Several draining methods have been suggested, including needle aspiration (NA), incision and drainage (ID), or abscesstonsillectomy. However, a gold standard of surgical therapy still does not exist. The aim of this study was to evaluate the outcome in patients who had undergone ID supplemented by cranial tonsillotomy (IDTT) as first-line treatment. A retrospective chart review of all patients who had undergone IDTT at our department in 2015 was performed. Demographic data, clinical findings, pain intensity on a 10-point visual analog scale, operation time and routine bloods before and after IDTT were collected. In addition, a 10-point visual analog scale (VAS) was utilized to measure personal satisfaction 2 weeks and 2 months after surgery. A total of 104 procedures were performed in 65 male and 38 female patients (median age 35 years), including one patient with a contralateral PTA 2 weeks after IDTT. Three patients had experienced abscess formation after admittance for antibiotic treatment of acute tonsillitis. 57.7 % of all patients denied intake of antibiotic therapy in their history at initial presentation. Patients were hospitalized for 3 days (median). The median pain intensity (VAS) within the first three postoperative days was 2, 1 and 1, respectively. Two weeks and 2 months after surgery patients were highly satisfied with the procedure (median value 10). Bleeding complications did not occur. IDTT is a novel surgical concept and associated with great patient comfort. It is safe, easy to learn and associated with an early return to normal diet and physical activity. These findings are supported by a rapid normalization of white blood cell count and C-reactive protein. IDTT eliminates the necessity of painful re-draining of the wound cavity and is free of bleeding complications. In contrast to ID and NA, histological examination of tonsillar tissue is feasible to disclose a previously undetected malign disease. Further analysis is warranted to verify the success rate in the long-term.

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Peritonsillar abscess: remember to always think twice

Windfuhr

Zurawski

2015

Eur Arch Otorhinolaryngol

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Peritonsillar abscess (PTA) is the most common complication of acute tonsillitis resulting in fever, unilateral sore throat, odynophagia and trismus. This retrospective study was undertaken to analyze the clinical courses of 775 patients with two different methods of the first-line treatment. Abscess tonsillectomy (TAC) including contralateral tonsillectomy was preferably performed between 2007 und 2010 (group A; n = 443). After that, incisional drainage (ID) was chosen as first-line treatment between 2010 and 2013 (group B; n = 332). The data of the patients were pooled from the individual charts to evaluate the prevalence of smoking habits, the incidence of the recurrence/complication rates and the number/types of surgical procedures associated with each therapy modality. Replacing TAC by ID as first-line treatment of PTA resulted in a significant decrease of days of inpatient treatment (4 vs. 7 days) and hemorrhage rate (0.3 vs. 5.1 %). A second, third and fourth surgical revision procedure was performed with comparable rates in group A (21.6; 2.4; 0.5 %) and B (21; 4.9; 0.3 %). Smoking habits were reported by almost every second patient. ID as first-line treatment of PTA is capable to reduce the hemorrhage rate and length of inpatient observation significantly. To suggest ID as first-line PTA treatment mandates a close follow-up to indicate repeated drainage of residual pus at an early stage. Further analysis is warranted to verify whether a better surveillance in an academic teaching hospital or surgical modification of the ID is followed by a higher success rate. Smoking habits are overrepresented in PTA patients.

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Is Needle Aspiration for Peritonsillar Abscess Still as Good as We Think? A Long-term Follow-up

Cited by 20 publications

References 22 publications

Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Cranial tonsillotomy for peritonsillar abscess: what a relief!

Peritonsillar abscess: remember to always think twice

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