Management of the peritonsillar abscess: incision or abscess tonsillectomy

Abstract

Background: Although peritonsillar abscess (PTA, quinsy) and peritonsillitis are common ENT emergencies, management strategies in the Slovak Republic still vary among otolaryngologists. In order to find the most effective way of treatment, the two procedures—incision and drainage versus abscess tonsillectomy—were evaluated. Study design: Retrospective study. Materials and methods: In the period 1995–1999, 84 patients with peritonsillar abscess have been treated in our department (32 females and 52 males, average age 31 (18–78)). Incision with drainage has been done in 37 patients while abscess tonsillectomy has been done in 47 patients. All patients in both groups have also received antibiotic treatment. Results: From the group of the patients managed by incision and drainage, 25 have been treated on outpatient basis (3 visits in average (1–5)) while 12 patients required hospitalization with average hospitalization time 8.7 days. Abscess tonsillectomy has been done in 47 patients (as an emergency procedure immediately after admission to the hospital with average hospitalization of 5 days). Conclusion: According to our experience, abscess tonsillectomy is accepted as a method of choice in the management of peritonsillar abscess due to following advantages against incision and drainage:•Effective drainage even in the deep or multifocal abscess•Earlier recovery•Painless surgery under general anesthesia•Tonsillectomy is done while majority of patients treated with incision do not respect our recommendation for tonsillectomy.