PERITONSILLAR ABSCESS: CLINICAL PRESENTATION AND EFFICACY OF INCISION AND DRAINAGE UNDER LOCAL ANAESTHESIA
AbstractBackground: Peritonsillar abscess (PTA) is one of the most commonly encountered abscess in thehead and neck region. The aims of this study were to list the frequency of the disease by age, sex andlaterality, and to list the presentation of the disease by symptoms, signs and complications, and todetermine the efficacy of incision and drainage (I&D) procedure under local anaesthesia (LA) in termsof hospital stay and recurrence. Methods: This descriptive study was conducted at the Department ofOtorhinolaryngology and Head & Neck Surgery, District Headquarters Hospital, Lakki Marwat, from1st June 2007 to 30th May 2010. Adult patients (>15 years) of both sexes with unilateral peritonsillarabscess were included sequentially. Children (15 years or less), patients with acute follicular tonsillitisor peritonsillitis and those who refused incision and drainage under LA were excluded. All patientsreceived the same antibiotic Amoxicillin/Clavunate and underwent I&D procedure under LA. Results:Sixty patients were included in the study, 42 male and 18 female. Mean age of the patients was30.02±9.42 (range 16–50 years). It was more on the left side (35, 58.35%). Forty-four (73.35%)patients gave an antecedent history of tonsillitis. Three (5%) patients presented with complications.Mean hospital stay was 1.55±1.00 (range 1–5 days). All patients underwent I&D with no recurrence.Interval tonsillectomy was performed in 38 selected cases after 6 weeks. Conclusion: Incision anddrainage under LA still remains the gold standard procedure for peritonsillar abscess in our setup.Keywords: Peritonsillar abscess, incision and drainage, tonsillectomy
Khayr W. Taepke J. Management of peritonsillar abscess: needle
aspiration versus incision and drainage versus tonsillectomy. Am
J Therapeutics 2005; 12:344–50.
Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am
Fam Physcian 2002; 65:93-6.
Megalamani GS, Suria G, Manickan U, Balasubramanian
D, Jothimahalingam S.. Changing trends bacteriology of
peritonsillar abscess. J Laryngol Otol 2007; 27:1–3.
Ono K, Hirayama C, Ishii K, Okamoto Y, Hidaka H. Emergency
airway management of patients with peritonsillar abscess. J
Anesth 2004; 18(1):55–8.
Ozbeck C, Aygenc E, Tuna EU, Selcuk A. Ozdem C. Use of
steroids in treatment of peritonsillar abscess. J Laryngol Otol
Tyagi V, Kaushal A, Garg D, De S, Nagpure P. Treatment of
peritonsillar abscess- A prospective study of aspiration versus
incision and drainage. Calicut Med J 2011;9(3):e3.
Hasan ZU, Akbar F, Saeedullah. Optimum treatment of
peritonsillar abscess. Pak J Otolaryngol 2005; 21:50–2.
Mastuda A, Ianaka H, Kanaya T, Kamata K, Hasegawa M.
Peritonsillar abscess: a study of 724 cases in Japan. Ear Nose
Throat J 2002;81:384–9.
Schraff S, McGinn JD, Derkay CS. Peritonsillar abscess in
children: a 10-year review of diagnosis and management. Int J
Pediatr Otolaryngol 2001; 57:213–8.
Iqbal SM, Husain A, Mughal S, Khan IZ, Khan IA. Peritonsillar
cellulites and quinsy, clinical presentation and management.
Armed Forces Med J 2009;59(4):275–80.
Shaikh RK. Treatment of peritonsillar abscess and role of
steroids. J Liquat Uni Med Health Sci 2008;1:31–33.
Kara N, Spinou C. Appropriate antibiotics for peritonsillar
abscess- a 9 month cohort. Otorhinolaryngologia Head Neck
Watanabe T, Suzuki M. Bilateral peritonsillar abscesses: our
experience and clinical features. Ann Otol Rhinol Laryngol
Mehmood T, Irshad-ul-Haq M. Presentation and management of
peritonsillar sepsis. J Coll Physcian Surg Pak 2000;10(6):209–12.
Ong YK, Goh YH, Lee YL. Peritonsillar infections: local
experience. Singapore Med J 2004;45(3):105–9.
Irani BS, Martin-Hirsch D, Lannigan F. Infection of the neck
spaces: a present day complication. J Laryngol Otol
Harris WE. Is a single quinsy an indication of tonsillectomy?
Clin Otolaryngol 1991;16:271–3.