PERITONSILLAR ABSCESS: CLINICAL PRESENTATION AND EFFICACY OF INCISION AND DRAINAGE UNDER LOCAL ANAESTHESIA

Authors

  • Muhammad Ismail Khan
  • Asmatullah Khan
  • Muhammad Muhammad

Abstract

Background: 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

References

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

;118(6):439–42.

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

Surg 2010;40:20–4.

Watanabe T, Suzuki M. Bilateral peritonsillar abscesses: our

experience and clinical features. Ann Otol Rhinol Laryngol

;10:662–6.

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

;106:455–8.

Harris WE. Is a single quinsy an indication of tonsillectomy?

Clin Otolaryngol 1991;16:271–3.

Published

2011-12-01

Issue

Vol. 23 No. 4 (2011): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.