Abstract
SummaryAimsThe objective of the present study was to determine the specificity, sensitivity and accuracy of intraoral and transcutaneous ultrasound (US) in the diagnosis of peritonsillar cellulitis and abscess.Study DesignClinical-Prospective.Materials and MetodsThirty nine patients were seen at the otorhinolaryngology emergency department of the University Hospital, of the School of Medicine, University of São Paulo, with a clinical diagnosis of peritonsillar cellulitis or abscess. After initial evaluation, all patients were submitted to intraoral and transcutaneous US.ResultsIntraoral US was performed on 35 cases and its sensitivity was of 95.2%, the specificity was of 78.5% and the accuracy was of 86.9%. Transcutaneous US was feasible in all 39 patients and diagnosed peritonsillar abscess in 53.8%. There were 5 false-negatives and 1 false-positive result, sensitivity was 80%, specificity was 92.8% and accuracy was 84.5%.ConclusionsIntraoral US was quite sensitive in the diagnosis of peritonsillar abscesses when performed by an experienced radiologist. Specificity was higher for transcutaneous US compared to intraoral US. However, when transcutaneous US was performed in patients with trismus, it was able to diagnose all peritonsillar abscesses, since they were large collections which are common in patients with trismus. These exams showed similar accuracy.
Highlights
The peritonsillar space is located between the palatine tonsil fibrous capsule and the fascia of the superior constrictor muscle, being the most common site of abscess formation in the head and neck[1]
It is typically more common in adolescents and young adults resulting from propagation of tonsillar infections, which lead to cellulitis or peritonsillar abscesss[2]
The differential diagnosis between cellulitis and peritonsillar abscesses is made by needle aspiration and careful aspiration of the peritonsillar space[8,9]
Summary
The peritonsillar space is located between the palatine tonsil fibrous capsule (medially) and the fascia of the superior constrictor muscle (laterally), being the most common site of abscess formation in the head and neck[1]. It is typically more common in adolescents and young adults resulting from propagation of tonsillar infections, which lead to cellulitis or peritonsillar abscesss[2]. Peritonsillar abscesses and cellulitis have a similar presentation that is almost impossible to differentiate based on the clinical history and the physical examination[3,6,7]. Ultra-sound (US) has been used in the diagnosis of abscesses since 1950; in past 15 years it has become much more frequently used in medical conditions
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