National prospective cohort study of peritonsillar abscess management
                    and outcomes: the Multicentre Audit of Quinsies study

Mehanna, Hisham

doi:10.1017/s0022215116008173

Cited by 18 publications

(4 citation statements)

References 14 publications

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“…Although those with smoking history were more likely to have a PTA as compared to non-smokers, this could be due to the relatively low incidence rate of PTA found on CT imaging. Much like the previous literature on the topic from across the world, it remains unclear if smoking predisposes a patient to the development of a PTA in a rural setting [6][7][8][9][10][11][12][13]. Larger studies examining a diverse patient population will be needed to further draw a correlation between smoking and PTA formation.…”

Section: Discussionmentioning

confidence: 99%

“…Data from several recent retrospective and prospective trials have shown a direct correlation between a patient's smoking history and the development of a PTA, where smokers are more likely to develop the infection as compared to non-smokers [6][7][8][9][10]. The increased risk for developing a PTA in smokers most likely occurs due to multiple processes: alteration of tonsillar bacterial flora, local and systemic immunological changes, and direct injury of the oropharyngeal mucosa [6][7][8][9][10]. Critically, as the smoking pack-years of a patient increases, the likelihood of these adverse effects leading to the development of a PTA increases.…”

Section: Introductionmentioning

confidence: 99%

“…Data on the correlation between smoking and the development of a PTA is currently limited and comes from countries other than the United States, where dedicated smoking cessation programs have proliferated [6][7][8][9][10][11][12][13]. Though a reduction in the rates of smoking has been seen nationwide, the rate of smoking in rural communities continues to be higher than in metropolitan areas and is associated with greater severity of negative health outcomes [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Smoking Behavior in Patients With Peritonsillar Abscess: A Rural Community Hospital's Experience

Clark¹,

Santarelli²,

Merrill³

et al. 2022

Cureus

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BackgroundPeritonsillar abscesses (PTA) are the most common deep space infection of the head and neck. They appear to have an association with a patient's smoking history but data showing this relationship is sparse and controversial. Currently, no data on this association exists for those who seek care at a rural community emergency department (ED). Based upon the lack of data in this setting, the authors sought to determine the incidence, treatments, and outcomes between smokers and non-smokers with a PTA at a rural community ED. MethodsA retrospective chart review of all patients undergoing a soft tissue neck computed tomography (CT) scan with or without intravenous contrast was completed from September 25th, 2019 through October 4th, 2021. Patients with a previously diagnosed PTA and those diagnosed via another means (clinical, needle aspiration, etc.), or outside of the ED were excluded from the dataset. Abstracted data included demographics, treatments, and outcomes of each patient. The data were analyzed using the Mann-Whitney test for continuous data and the chi-square test for categorical data. ResultsDuring the study period, a total of 50 patients were diagnosed with a PTA via soft tissue neck CT. Of those diagnosed, the median age was 40.5 (25.5 -53.3) years, 15 were female, 38 self-identified as white, and 27 noted a current smoking history. Smokers presented to ED earlier than non-smokers (2.0 vs 4.0 days; p=0.03), but no difference was noted in the size of PTA identified via CT (2.0 vs 1.5 cm; p=0.13). No difference among smokers and non-smokers was noted in corticosteroid therapy either administered in the ED (p = 0.53) or prescribed as an outpatient (p = 0.75), incision and drainage (p = 0.19), outpatient follow-up (p = 0.53), or resolution of the symptoms (p = 0.86). However, more patients in the non-smoking group had an unplanned return to the ED as compared to those who smoked (p=0.02). In those patients who were not discharged from the ED after initial presentation, four were admitted to the hospital and 11 were transferred to a higher level of care. ConclusionAlthough drawn from a limited sample from a single rural community ED, a positive smoking history was more common among patients with a PTA. While there was no statistically significant difference in the overall treatment, a difference was noted for unscheduled return visits to the ED in those without a history of smoking.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of Smoking Behavior in Patients With Peritonsillar Abscess: A Rural Community Hospital's Experience

Clark¹,

Santarelli²,

Merrill³

et al. 2022

Cureus

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“…Across the collaboratives, eight cohort or observational research projects and 24 audits were underway or completed. Notable successes have included three multicentre audits; retrospective tonsillectomy [5] and pinna haematoma [6] audits, and the prospective quinsy management audit which was the first within the specialty to establish the feasibility of large-scale online data collection [7]. An ENT trainee collaborative has yet to deliver a randomised controlled trial, though they are in development.…”

Section: Ent Trainee Collaboration: How We Do Itmentioning

confidence: 99%

ENT audit and research in the era of trainee collaboratives

Smith

Hardman

Ellis

et al. 2018

Eur Arch Otorhinolaryngol

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Large surgical audits and research projects are complex and costly to deliver, but increasingly surgical trainees are delivering these projects within formal collaboratives and research networks. Surgical trainee collaboratives are now recognised as a valuable part of the research infrastructure, with many perceived benefits for both the trainees and the wider surgical speciality. In this article, we describe the activity of ENT trainee research collaboratives within the UK, and summarise how INTEGRATE, the UK National ENT Trainee Research Network, successfully delivered a national audit of epistaxis management. The prospective audit collected high-quality data from 1826 individuals, representing 94% of all cases that met the inclusion criteria at the 113 participating sites over the 30-day audit period. It is hoped that the audit has provided a template for subsequent high-quality and cost-effective national studies, and we discuss the future possibilities for ENT trainee research collaboratives.

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Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy‐A Meta‐Analysis

Mughal,

Gupta,

Yeo

et al. 2024

The Laryngoscope

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ObjectiveAbscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post‐tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.Data SourcesA search was performed on August 27, 2023 in Medline, Embase, PubMed, Cochrane CENTRAL, and Web of Science databases.Review MethodsThe systematic review was conducted in adherence to the PRISMA guidelines. Pooled PTB rate was determined using a meta‐analysis of proportions. The JBI tool was used to assess the quality of the included studies.ResultsOf the 525 search records, 18 studies met the eligibility criteria for final analysis. These comprised of retrospective single‐center analyses. The pooled prevalence of PTB was 6.65% (95% C.I. 4.01–9.81), and the return‐to‐theatre rate was 2.35% (95% C.I. 1.48–3.37). There was no difference in PTB rate between unilateral and bilateral tonsillectomy. However, the bipolar technique was associated with a higher PTB rate compared to cold steel dissection. The overall quality of the body of evidence was moderate.ConclusionOur study highlights the complications associated with abscess tonsillectomy. These findings contribute valuable insights into this potential treatment option for quinsy.Level of EvidenceN/A Laryngoscope, 2024

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National prospective cohort study of peritonsillar abscess management and outcomes: the Multicentre Audit of Quinsies study

Abstract: Out-patient management of peritonsillar abscess is not commonly practised in the UK. Corticosteroid usage is common and appears safe. This study demonstrates that trainees working in collaboration can effectively deliver prospective multicentre cohort studies in the UK.

Cited by 18 publications

References 14 publications

Analysis of Smoking Behavior in Patients With Peritonsillar Abscess: A Rural Community Hospital's Experience

Analysis of Smoking Behavior in Patients With Peritonsillar Abscess: A Rural Community Hospital's Experience

ENT audit and research in the era of trainee collaboratives

Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy‐A Meta‐Analysis

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