Peritonsillar abscess (PTA) Management: A literature review comparing different approaches of PTA drainage.
Background:Peritonsillar abscess (PTA) is the most common deep infection of neck space that occurs in adults and is potentially life threatening if not treated appropriately. The surgical treatment of peritonsillar abscess that is not complicated with upper airway obstruction still remains controversial. Objectives: This review attempts to explore the controverseries between different types of management and compare the efficacy of needle aspiration, tonsillectomy and/or incision and drainage. Methodology: This study was done in King Abdulaziz University. All researches, between 1988 to 2015 were recruited and reviewed in this study. Results and conclusion: Studying the three accepted methods of draining: incision and drainage, abscess tonsillectomy, or needle aspiration, Incision and drainage is an efficient and safe procedure to treat peritonsillar abscess. As well as it is superior to Needle aspiration in terms of the post-procedure pain score. It can be performed as the first-line treatment of peritonsillar abscess. Quinsy tonsillectomy can offer several advantages, by allowing full evacuation of the abscess cavity, effectively relieving symptoms, but holds risk in general anesthesia intubation. and also higher post-operative complication like Peritonsillar abscess make it not a favorable step.
E. M. Liebler-Tenorio and R. Pabst, “MALT structure and function in farm animals,” Veterinary Research 2006; vol. 37, no. 3, pp. 257–280.
C. Casteleyn,Morphological characteristics of the ovine tonsils— a study of their volume and surface area, lymphoid tissue organization, lining epithelia and vascular architecture, Ph.D. thesis, Faculty of VeterinaryMedicine, Ghent University, 2010.
M.Manesse, J. Sautet, M. Delverdier, F. Schelcher, J. Espinasse, and P. Cabanie, “Anneau de Waldeyer des bovins: anatomie topographique et microscopique des tonsilles,” Revue de M´edecine V´et´erinaire 1995; vol. 146, pp. 749–756
M. Perry and A. Whyte, “Immunology of the tonsils,” Immunology Today 1998; vol. 19, no. 9, pp. 414–421
Susan S, Harold E, Jermiah CH, David J, Andrew W. Pharynx (chapter 35). Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 39th ed. Philadelphia: Elsevier; 2005. 619-631
Beasley P. Anatomy of the pharynx and oesophagus. Kerr AG, Gleeson M. Scott-Brown’s Otorhinolaryngology. 6th ed. India: Butterworth-Heinemann publications; 1997. 1: 1/10/1 to 1/10/40.
Brandtzaeg P. Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol 2003; 67 Suppl 1:S69-76
Ball SL, Siou GP, Wilson JA, Howard A, Hirst BH, Hall J. Expression and
immunolocalisation of antimicrobial peptides within human palatine tonsils. J Laryngol Otol 2007; 121:973-8
Böck A, Popp W, Herkner KR. Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children. Eur Arch Otorhinolaryngol 1994; 251:423-7
Stedman J. Stedman’s Medical Dictionary. Philadelphia, USA: Lippincott
Williams & Wilkins, 2006.
Galioto N. Peritonsillar abscess. Am Fam Physician 2008; 77: 199–202.
Monobe H, Suzuki S, Nakashima M, Tojima H, Kaga K. Peritonsillar abscess with parapharyngeal and retropharyngeal involvement: incidence and intraoral approach. Acta Otolaryngol Suppl (Stockh) 2007; 559:91-4
Marom T, Cinamon U, Itskoviz D et al. Changing trends of peritonsillar
abscess. Am J Otolaryngol 2010; 31: 162–7.
Sunnergren O, Swanberg J, Mo¨ lstad S. Incidence, microbiology and
clinical history of peritonsillar abscesses. Scand J Infect Dis 2008; 40:
Passy V. Pathogenesis of peritonsillar abscess. Laryngoscope 1994; 104:
Ong Y, Goh Y, Lee Y. Peritonsillar infections: local experience.
Singapore Med J 2004; 45: 105–9.
Chen Z, Zhou C, Chen J. [Investigation of the infectious route of
peritonsillar abscess.] Zhonghua Er Bi Yan Hou Ke Za Zhi 1997; 32: 245–6.
Ball S, Siou G, Wilson J et al. Expression and immunocolocalisation of
antimicrobial peptides within human palatine tonsils. J Laryngol Otol
; 121: 973–8.
Dang J, Athavale SM, Teng J et al. Salivary flow rate and peritonsillar
abscess development: a prospective cohort study. Laryngoscope 2011; 121:
Risberg S, Engfeldt P, Hugosson S. Incidence of peritonsillar abscess and relationship to age and gender: retrospective study. Scand J Infect Dis 2008; 40:792-6
J. T. Edinger, E. Y. Hilal, and K. J. Dastur, “Bilateral peritonsillar abscesses: a challenging diagnosis,” Ear, Nose and Throat Journal 2007; vol. 86, no. 3, pp. 162–163
R. E. Dalton, E. Abedi, and A. Sismanis, “Bilateral peritonsillar
abscesses and quinsy tonsillectomy,” Journal of the National
Medical Association 1985; vol. 77, no. 10, pp. 807–812.
C. J. Fasano, C. Chudnofsky, and P. Vanderbeek, “Bilateral peritonsillar abscesses: not your usual sore throat,” Journal of Emergency Medicine 2005; vol. 29, no. 1, pp. 45–47
K. Kanesada and G. Mogi, “Bilateral peritonsillar abscesses,” Auris Nasus Larynx 1981; vol. 8, no. 1, pp. 35–39
Khayr W, Taepke J. Management of peritonsillar abscess: needle aspiration versus incision and drainage versus tonsillectomy. Am J Ther 2005; 12:344-50
Mehanna H.M., Al-Bahnasawi L. & White A. National
audit of the management of peritonsillar abscess. Postgrad. Med 2002; 78, 545–548
Maharaj D, Rajah V, Hemsley S. Management of peritonsillar abscess. J Laryngol Otol. 1991; 105: 743-45)
Chang BA, Thamboo A, Burton MJ, Diamond C, Nunez DA.
Needle aspiration versus incision and drainage for the treatment of peritonsillar abscess. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD006287.DOI: 10.1002/14651858.CD006287.pub4.
Chanan Shaul, MD, Benjamin Koslowsky, MD, Mercedes Rodriguez, MD,Yehuda Schwarz, MD1, Nidal Muahnna, MD, PhD1, Uri Peleg, MD1,and Jean-Yves Sichel, MD1, Is Needle Aspiration for Peritonsillar Abscess Still as Good as We Think?A Long-term Follow-up, Annals of Otology, Rhinology & Laryngology 2015; Vol. 124(4) 299–304)
Herzon FS, Harris P. Mosher Award Thesis. Peritonsillar abscess: Incidence, current management practices, and a proposal treatment guidelines. Laryngoscope. 1995;105:117)
Wikstén J, Hytönen M, Pitkäranta A, Blomgren K. Who ends up having tonsillectomy after peritonsillar infection? Eur Arch Otorhinolaryngology. 2011)
Khan MI, Iqbal K, Muhammad. Peritonsillar abscess:comparison of outcome of incision and drainage versus needle aspiration. Gomal Journal of Medical Sciences 2012;10(2):205–8.
Spires JR, Owens JJ, Woodson GE, Miller RH. Treatment
of peritonsillar abscess. Archives of Otolaryngology - Head &
Neck Surgery 1987;113:984–6.
Younas M. Satisfaction of patients with peritonsillar abscess
with permucosal needle aspiration versus incision &
drainage. Medical Forum Monthly 2015;26(3):37–9.
Fagan J.J. & Wormald P.J. Quinsy tonsillectomy or interval
tonsillectomy–a prospective randomised trial. S. Afr. Med. J. 1994;
Fagan J.J. & James M.F. A prospective study of anaesthesia
for quinsy tonsillectomy. Anaesthesia. 1995; (50), 783–785
Ryan C., Dutta C. & Simo R. Role of screening for infectious mononucleosis in patients admitted with isolated, unilateral peritonsillar abscess. J. Laryngol. Otol.2004; 118, 362–365
Windfuhr J.P. & Chen Y.S. Immediate abscess tonsillectomy–
a safe procedure? Auris Nasus Larynx 2001; 28, 323–327
Lowe D., van der Meulen J., Cromwell D. et al. Key messages
from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117, 717–724
Lehnerdt G., Senska K., Jahnke K. et al. Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy. Acta Otolaryngol.2005; 125, 1312–1317
Lockhart R, Parker GS, Tami TA. Role of quinsy tonsillectomy in the management of peritonsillar abscess. Ann Otol, Rhinol & Laryngol 1991; 100:569-571
Berry S, Pascal I, Whittet HB. Tonsillectomy a chaud for quinsy: revisited. Eur Arch Otorhinolaryngol 2008; 265:31-3
Klug TE, Henriksen JJ, Fuursted K, Ovesen T. Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis 2011; 30:619-27
Cannon CR, Lampton LM. Peritonsillar abscess following tonsillectomy. J Miss
State Med Assoc 1996; 37: 577–579.
Sadler TW. Langman’s Medical Embryology. 6th edn. Baltimore, MD: Williams
& Wilkins; 1990
Stankiewicz JA, Talland C. Peritonsillarlike lateral oropharyngeal abscess after
tonsillectomy. Arch Otolaryngol Head Neck Surg 1988; 114: 1,181–1,183.
Al-Kindy S. Post tonsillectomy quinsy. Saudi Med J 2002; 23: 240–241
Al-Barrak H. Post tonsillectomy quinsy. Saudi Med J 2003; 24: 315.
SEJ Farmer, MA Khatwa, HMM Zeitoun Ann R Coll Surg Engl 2011; 93: 353–357
doi 10.1308/ 003588411X579793 Peritonsillar abscess after tonsillectomy:
a review of the literature
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.