Treatment Of Peritonsillar Abscess Research Articles

Treatment of Peritonsillar Abscess in Children: A Systematic Review.

Objectives: This review aims to analyze the treatment options for peritonsillar abscess (PTA) in children. Methods: We searched PubMed and EMBASE for studies regarding the treatment of PTA in children. Relevant studies were reviewed based on systematic review (PRISMA) guidelines. Qualitative and quantitative analyses of the extracted data were performed. Results: A total of 12 articles with 2211 cases of PTA were found to be eligible. All the identified studies were retrospective cohorts. The mean age varied from 8.5 to 15.4 years without gender difference. Treatment options included broad-spectrum antibiotic therapy with incision and drainage of the abscess, needle aspiration and immediate tonsillectomy in 69%, 7.6% and 7% of cases, respectively. Antibiotics alone were administered to 16.4% of the subjects. The rate of recurrence of PTA after primary treatment ranged from 2% to 15.8% of cases. The time of recurrence is considered within one or two months. Complications in children with PTA were torticollis, prolonged fever, sepsis, dyspnea and parapharyngeal involvement. Conclusions: The mainstay of treatment of PTA in children is antibiotic therapy with incision and drainage of the abscess. Alternatives include antibiotic treatment alone or in association with needle aspiration. Immediate tonsillectomy is reserved only for a few high-risk patients.

National survey on peritonsillar abscess treatment and attitudes toward quinsy tonsillectomy

ABSTRACT Objectives Peritonsillar abscess (PTA) is a common deep neck infection traditionally managed with conservative measures. Quinsy Tonsillectomy (QT) is recognized as a definitive treatment but remains variably utilized. We aimed to investigate PTA management strategies and attitudes toward QT among otolaryngologists. Methods An anonymous questionnaire was distributed to members of the local national Society of Otolaryngology, evaluating treatment strategies based on patient characteristics and clinical scenario. Results A total of 108 otolaryngologists responded (response rate: 30.8%). Participants preferred to treat PTA patients as inpatients (89%) and predominantly offered incision and drainage (I&D) as the first (90.7%) and subsequent (98.1%) treatment plan. QT was favored as a primary treatment only in 1.9% of responders. QT adoption increased with multiple I&D failures, reaching 95.3% after four attempts. In patients with recurrent PTA or tonsillitis, 84.2% preferred I&D follows by interval elective tonsillectomy, while 15% considered QT. The most common reason (72.2%) to avoid QT was the perception of a high perioperative risk. Conclusion I&D was favored for initial PTA treatment. QT is considered after multiple failed I&D attempts, and its use is limited as a primary treatment, mainly due to concerns regarding perioperative risk.

Therapeutic management of peritonsillar abscess during COVID-19.

The purpose of this study is to examine the effects of the Covid-19 pandemic and lockdown policies in Germany on frequency and treatment of peritonsillar abscess at a tertiary referral center in Germany. This retrospective case-control study analyzed all cases of peritonsillar abscess treated from 03/01/2018 until 08/30/2022 at Augsburg ENT University Hospital, Germany, through abscess tonsillectomy and/ or incisional drainage. Data was collected and correlated to Covid-19 Stringency Index using codes based on the Institute for Hospital Remuneration System in Germany. After excluding 303 cases, 975 abscess tonsillectomy and incisional drainage cases were studied, with the first German lockdown serving as cutoff date. Treatment algorithm was maintained regardless of co-infection with Covid-19. A total of 174 patients received abscess tonsillectomy as therapy, while 801 patients underwent incisional drainage. Before the first German lockdown, 452 patients received incisional drainage. Since the pandemic, 349 cases of incisional drainage were registered (OR = 0.54, 95%-CI [0.27-0.86], p = 0.04), despite no significant change in the percentage of peritonsillar abscess of all ENT emergencies. The mean age at presentation with PTA was 39.8 years, and the rate of relapse was 4.0%. The study found no association between the scale of policy measures and treatment (OR = 1.00, 95%-CI [0.99-1.01], p = 0.52). The results indicate that, despite the reduction in capacities due to Covid-19, the proportion of patients with peritonsillar abscess treated through abscess tonsillectomy increased at Augsburg ENT University Hospital since the first German lockdown. Hospitalization times could still be reduced with comparable relapse rates.

The Use of Point of Care Ultrasound in Diagnosis of Peritonsillar Abscess

The use of point of care ultrasound (POCUS) for diagnosis and treatment of peritonsillar abscess (PTA) is increasing [1]. Proven advantages include improved diagnostic accuracy and treatment success rates as well as decreased otolaryngology consultation, computed tomography (CT) usage, return visits to the emergency department (ED), and length of stay [1]. We present a case of a patient with a PTA that was diagnosed and successfully treated utilizing POCUS, avoiding the need for otolaryngology consultation and CT.

A systematic review of the role of penicillin versus penicillin plus metronidazole in the management of peritonsillar abscess.

Peritonsillar abscess is a localised infection in the peritonsillar space. Pus from the abscess can contain anaerobes. Many clinicians prescribe metronidazole in addition to penicillin, but evidence to support this is limited. This review assessed the evidence of benefit of metronidazole for the treatment of peritonsillar abscess. A systematic review was conducted of the literature and databases including Ovid Medline, Ovid Embase, PubMed and Cochrane library. Search terms included all variations of peritonsillar abscess, penicillin and metronidazole. Three randomised, control trials were included. All studies assessed the clinical outcomes after treatment for peritonsillar abscess, including recurrence rate, length of hospital stay and symptom improvement. There was no evidence to suggest additional benefit with metronidazole, with studies suggesting increased side effects. Evidence does not support the addition of metronidazole in first-line management of peritonsillar abscess. Further trials to establish optimum dose and duration schedules of oral phenoxymethylpenicillin would benefit clinical practice.

Prevalence of peritonsillar abscesses in children of the Tyumen region

Introduction. Peritonsillar abscess (PTA) is a suppuration of the peritonsillar fiber, which is more often a complication of acute tonsillitis, requires urgent medical care. Issues of diagnosis and treatment of PTA are one of the urgent problems of pediatric otorhinolaryngology. The main peak of the incidence occurs in adolescence, which is associated with a change in the immunobiological properties of the body at this age. In children under 3 years of age, the disease is extremely rare, but the increase in the number of PTA in children from 4.2 to 12.1% and the development of peritonsillitis in children under 3 years of age are alarming about the severity of post-streptococcal complications. Timely diagnosis, treatment and prevention of PTA are essential to prevent potential serious complications.Aim. To study the prevalence of PTA in children, to analyze the results of prevention with a herbal preparation.Materials and methods. A sample of medical histories of 19,017 people hospitalized in the children’s ENT department of Regional Clinical Hospital No. 2 (Tyumen) was carried out, the prevalence of PTA and other diseases of the pharynx was studied. The duration of prospective observation of patients was 10 years (2009–2019). Clinical data such as sore throat, enlargement of the cervical and submandibular lymph nodes, fever, dysphagia, nasality of the voice, trismus of the masticatory muscles were analyzed. Gender, age characteristics, data on relapse were evaluated. All patients with PTA were opened and drained of the purulent cavity with the appointment of antibacterial therapy and the herbal preparation in the postoperative period.Results. The highest incidence of PTA is observed in children of middle and high school age, more often girls are sick – 52% of cases. A more rapid relief of the main symptoms and relapses of PTA was recorded in the group of children who received the herbal preparation as a prophylaxis.Conclusions. The prevalence of PTA in childhood does not tend to decrease. Prophylactic use of the herbal preparation in the postoperative period contributes to a more rapid relief of the main symptoms of PTA and prevention of recurrence of the disease.

Scope of Homoeopathy in Peritonsillar Abscess

A Peritonsillar abscess is also known as Quinsy. It is an accumulation of pus behind the palatine tonsil due to an infection. Precisely, it is a collection of pus between the fibrous capsule of the tonsil, usually at the upper pole & the superior constrictor muscles of pharynx. The signs & symptoms of quinsy include fever, throat pain, trouble in opening mouth, redness, swelling and change in the voice. Pain is usually worse on one side. The complications may include blockage of the airway or aspiration pneumonitis. The conventional treatment is done for removing the pus by incision & drainage along with medications for swelling & pain management. The homeopathic line of treatment depends on the actual state of the condition. Homeopathic medicines can be used in mild to moderate cases of peritonsillar abscess successfully as see through this research study. In this study, 46 cases of peritonsillar abscess of age group between 5 to 80 years were included. After going through the results, it is observed that the peritonsillar abscess can be treated successfully by Homoeopathy. The scope of Homoeopathy in the treatment of peritonsillar abscess is excellent and shows high success rate of 44 out of 46 patients responding successfully to the Homoeopathic treatment with no signs of recurrence in near future. The outstanding Homoeopathic remedies in the treatment of peritonsillar abscess were found to be mostly Hepar Sulph & Merc Sol along with Calc Carb, Baryta Carb and Phytolacca. All that is required in the treatment of peritonsillar abscess is quick selection of right remedy and right dose for the instant relief rationally. Hence we can rightly claim that by proper Homoeopathic treatment we can make the world better for the future generation. This research paper will certainly help the health professionals to overcome such problems of surgical cases and consider the benefits of the facts in scope of Homoeopathy in peritonsillar abscess.

Peritonsillar Abscess Treatment under Local Anaesthesia: Incision and Drainage versus Needle Aspiration

Background: Peritonsillar abscess is usually complication of acute tonsillitis which itself is prevalent in society. As a general surgical principle, abscess any were, has to be drained so same applies for quinsy but methodology for this drainage is not being agreed. Aim: To find best modality for drainage of this abscess and see its incidence in which age group and sex. Study design: Prospective study Place and duration of the study: Department of ENT, Rai Medical College, Sargodha from 1st Feb. 2017 to 31st Jan. 2019. Methodology: One hundred and thirty five patients above 15 years of age and those in need of hospital admission due to severity of symptoms were included. Paediatric, immunocompromised, requiring general anesthesia and acute tonsillitis patients were excluded. Results: There were 65.2% males and 34.8% females. Commonly affected age group was 21-40 years. Needle aspiration was found more effective for management of peritonsillar abscess. Conclusion: No consensus for single modality and both needle aspiration and incision/drainage is advocated and needle aspiration proved fruitful in management. Keywords: Quinsy, Peritonsillar abscess, needle aspiration

Management of Peritonsillar Abscesses in Adults: Survey of Otolaryngologists in Canada and the United States.

ObjectiveThe management of peritonsillar abscess (PTA) has evolved over time. We sought to define contemporary practice patterns for the diagnosis and treatment of PTA.Study DesignCross-sectional survey.SettingThe 15-question survey was distributed to members of the Canadian Society of Otolaryngology–Head and Neck Surgery (CSO) and the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS).MethodsAn iterative, consensus-based process was used for survey development. Primary outcomes were to determine methods of diagnosis and first-line treatments for PTA. Exploratory, secondary outcomes were analyzed using multivariable logistic regression models.ResultsThe survey response rate was 12.6% (n = 1176). Most participants were attending staff (86%) in a community hospital setting (60%) and had been in practice for more than 20 years (38%). Most respondents (78%) indicated that at least half of the time, cross-sectional imaging had already been performed before they were consulted. Half of respondents (49%) indicated that they perform incision and drainage of the abscess as first-line treatment, while few (16%) provide medical management alone. In exploratory analysis, participants from the AAO-HNS had higher odds of imaging already being performed before consultation (odds ratio [OR], 11.7; 95% CI, 4.6-29.4) and increased odds of using medical management alone as a first-line treatment (OR, 2.4; 95% CI, 1.3-4.2) compared to respondents from the CSO.ConclusionThere is wide practice variation in the diagnosis and management of acute, uncomplicated PTA among otolaryngologists in Canada and the United States. The use of cross-sectional imaging and medical management alone may differ between countries of practice.

The Surgical Treatment of Peritonsillar Abscess: A Retrospective Analysis in 584 Patients.

There are three surgical treatment options for patients with peritonsillar abscess (PTA): needle aspiration, incision and drainage (ID), and abscess tonsillectomy (ATE). The updated German national guideline (2015) included changes in the treatment of PTA. The indication for tonsillectomy (TE) in patients became more stringent and preference was given to ID in certain cases. Retrospective analysis. We performed a retrospective systematic analysis of patient data using the in-house electronic patient records and considered a 4-year period from 2014 to 2017. About 584 patients were identified. Our aim was to analyze the influence of the updated guideline on clinical practice. 236 of 584 patients (40.4%) underwent ATE with contralateral TE. In 225 patients (38.5%), unilateral ATE was performed. Mean surgery time was significantly shortened when only unilateral ATE was performed. Concerning postoperative bleeding, we noted a tendency toward a lower incidence after ATE in comparison to ATE with contralateral TE. Less than 1% of patients who underwent ATE had to be revised surgically due to postoperative hemorrhage. After the revision of the guideline, unilateral ATE and ID were conducted more frequently. These results support that ATE in an inpatient setting is a considerably safe and effective primary therapeutic option. ID represents a favorable treatment option for patients with PTA and comorbidities, nevertheless, patient compliance is required and insufficient drainage or recurrence of PTA may occur. The revision of the guideline had a significant impact on the choice of interventions (P< .001), which is reflected by the increased number of unilateral ATE. 4 Laryngoscope, 131:2706-2712, 2021.

The Effects of Adjunctive Steroids in the Treatment of Peritonsillar Abscess

Background and Objectives Steroids have strong anti-inflammatory, anti-edema, and antipyretic effects. Since there are few studies on the use of steroids in the treatment of peritonsillar abscess in Korea, we aimed at this study to investigate the effects of steroids along with antibiotics in the treatment of peritonsillar abscess.Subjects and Method A retrospective study was conducted on 75 patients who were admitted from 2014 to 2019. Between 2014 and 2017, only antibiotics were administrated after incisional drainage (no-use group), but between 2018 and 2019, antibiotics and adjunctive steroids were administrated after incisional drainage (steroids group). Symptoms of patients, blood tests, diets available, and hospitalization period were compared between the two groups.Results The length of hospital stay for the steroids group (n=24) and the no-use group (n=51) was 4.2±1.3 days and of 5.1±1.8 days (p=0.046), respectively, showing significantly shortened time for the steroids group. The rate of change in 48-hour C-reactive protein was 53.3% and 20% for the steroid group and no-use group (p=0.013), respectively. However, there was no differences between the two groups in the rate of change in body temperature at 12 hours of treatment, the diet available at 12 hours, and rate of change in the number of white blood cells after 48 hours of treatment.Conclusion Adjunctive steroids for peritonsillar abscess can be a useful treatment that shows rapid improvement of symptoms and C-reactive protein, and shorter hospitalization periods.

Empiric treatment for peritonsillar abscess: A single-center experience with medical therapy alone

PurposeCompare the use of medical therapy alone (MTA) with surgical therapy (ST) for the empiric treatment of peritonsillar abscess (PTA). Materials and methodsA consecutive cohort of patients treated for PTA at our institution from May 2013 to February 2019 was analyzed. Demographics, disease characteristics, management strategies, and treatment outcomes were compared between treatment groups. Primary outcomes included treatment failure, defined as the need for follow-up surgical intervention, and complications within 2-weeks of empiric treatment. Results306 patients (72.7%) received MTA while 115 (27.3%) underwent ST. There was no significant difference in the rate of treatment failure between the MTA (7.2%) and ST (6.1%) groups (p = 0.879). Complications were rare in both groups (1.6% with MTA versus 0.9% with ST; p = 0.898). Dysphagia (p = 0.011), trismus (p = 0.045), larger abscesses (p < 0.001), and hospital admission (p < 0.001) were more common in the ST group. Corticosteroid prescriptions were a common component of MTA (53.3%) and less often used with ST (33.9%; p = 0.001). After adjusting for abscess size, there remained no significant difference in the rate of treatment failure between groups. Univariate analyses demonstrated no significant independent predictors of treatment failure including age, sex, race, tonsillitis history, smoking history, presenting signs and symptoms, abscess size, hospital admission, and corticosteroid prescriptions. ConclusionsMTA may be a safe and effective alternative to surgical drainage for the empiric treatment of PTA, warranting larger-scale prospective analyses. Abscess size did not appear to influence treatment failure; however, careful patient selection is likely to optimize treatment outcomes.

The Efficacy of Needle aspiration along with antibiotics and short dose of steroid in the treatment of Peritonsillar abscess (Quinsy).

Background: Quinsy (also known as Peritonsillar abscess) can be defined as pus collection in peritonsillar space (between superior constrictor muscle of pharynx and lateral surface of tonsil). It is a common complication of tonsillitis. Materials &amp; Methods: This is a descriptive, prospective study. It was carried out on 27 consecutive patients which were treated for Quinsy from September 2016 to August 2018. All of the patients were hospitalized. Peritonsillar abscess was treated with aspiration of pus by wide bore needle followed by Antibiotics and short dose of steroid. Results: 74 % of patients were found to have previous history of recurrent tonsillitis. 56 percent of patients were already receiving antibiotics at the time of presentation. Mean hospital stay was two days. None of the patients required incision drainage. Recurrence was seen in only 3 patients. Conclusion: Needle-aspiration at the most prominent (bulging) part of the peritonsillar region followed by intravenous antibiotics and steroids is an effective treatment protocol. We also suggest further controlled studies on larger number of patients to establish its efficacy and safety.

The role of microbiological examination in treating peritonsillar abscess based on the retrospective analysis of data from six years

Peritonsillar abscess is the most common deep neck infection. Without adequate treatment, this otolaryngological disease pattern can cause life-threatening complications. The empirical choice of antibiotics is crucial which requires knowledge of the most common pathogens and the potential resistance. A retrospective analysis of cases treated for peritonsillar abscess was performed between 2012 and 2017. We summarized the aerobic and anaerobic culture results of the surgical samples and the empirically selected antibiotics. The most common pathogens were determined via routine microbiological culture tests. We compared our data with the results of international studies. During the 6-year study at our Clinic, 217 patients with peritonsillar abscess were treated. The microbiological tests were available for analysis in only 146 cases. In 47 cases, Fusobacterium species (including 25 cases with Fusobacterium necrophorum), in 31 cases Actinomyces species and in 29 cases Streptococcus pyogenes were isolated. In 2/3 of the patients, polymicrobial infection was detected. In the treatment of peritonsillar abscesses, surgical intervention can result in clinical improvement because of the elimination of the anaerobic milieu. A well-chosen antibiotic can accelerate the healing process and reduce the complication rate. Proper microbiological sampling is of great importance, and in cases of non-recovery or poor recovery, this may create the opportunity to switch for targeted antibiotic therapy. The results of this study show that polymicrobial flora is very important for the development of the peritonsillar abscess, thus the recommended antibiotic therapy is amoxicillin-clavulanic acid or 2nd/3rd generation cefalosporin combined with metronidazol or clindamycin. Orv Hetil. 2020; 161(44): 1877-1883.

Needle aspiration in peritonsillar abscess: our experience in Chitwan

Background: Peritonsillar abscess is one of deep neck space having significant morbidity and mor­tality. The treatment is still controversial regarding best method to perform. The aim of the study was to study the effect of needle aspiration in the treatment of peritonsillar abscess among the patients of Chitwan Medical College.&#x0D; Methods: A retrospective study was designed which included all aged patients and were admitted in tertiary centre for peritonsillar abscess treatment between January 2015 to December 2019. All patient was treated with needle aspiration method under local spray anaesthesia and intravenous antibiotics. Number of aspirations, hospital stay, recurrence and complications were assessed as main outcomes. Descriptive analysis was performed by using SPSS version 16.0.&#x0D; Results: Over 5-year duration, 57 patients were admitted for PTA and included for analysis. About 45(78.9%) of patients were under 40 years. Male dominance of 41(71.6 %) was found. All cases were unilateral and no significant laterality found. All patients had prior medications outside be­fore hospital visit. Length of hospital stay was 3.11+/-.939 days. Single or repeat aspiration of pus showed significant improvement of symptoms. One patient had recurrence and another one case had developed complication.&#x0D; Conclusions: Our study showed needle aspiration is effective modality for peritonsillar abscess treatment due to early clinical improvement, low recurrence and decrease hospital stay.

NEEDLE ASPIRATION IN PERITONSILLAR ABSCESS: OUR EXPERIENCE IN CHITWAN

Background: Peritonsillar abscess is one of deep neck space having significant morbidity and mor­tality. The treatment is still controversial regarding best method to perform. The aim of the study was to study the effect of needle aspiration in the treatment of peritonsillar abscess among the patients of Chitwan Medical College. Methods: A retrospective study was designed which included all aged patients and were admitted in tertiary centre for peritonsillar abscess treatment between January 2015 to December 2019. All patient was treated with needle aspiration method under local spray anaesthesia and intravenous antibiotics. Number of aspirations, hospital stay, recurrence and complications were assessed as main outcomes. Descriptive analysis was performed by using SPSS version 16.0. Results: Over 5-year duration, 57 patients were admitted for PTA and included for analysis. About 45(78.9%) of patients were under 40 years. Male dominance of 41(71.6 %) was found. All cases were unilateral and no significant laterality found. All patients had prior medications outside be­fore hospital visit. Length of hospital stay was 3.11+/-.939 days. Single or repeat aspiration of pus showed significant improvement of symptoms. One patient had recurrence and another one case had developed complication. Conclusions: Our study showed needle aspiration is effective modality for peritonsillar abscess treatment due to early clinical improvement, low recurrence and decrease hospital stay.

Evidence-Based Medicine Improves the Emergent Management of Peritonsillar Abscesses Using Point-of-Care Ultrasound.

Physical examination for peritonsillar abscess (PTA) has limited sensitivity. Traditional management involves blind needle aspiration, which has a false negative rate of 10-24%. A randomized controlled trial by Costantino etal. demonstrated that point-of-care ultrasound (POCUS) improves PTA management. Compare the use and impact of POCUS between patient cohorts prior to and after the trial by Costantino etal. Retrospective cohort study of adult patients diagnosed with PTA. Cohort 1 presented to the emergency department (ED) January 2007-December 2008. Cohort 2 presented between January 2013 and December 2014. Data were separated into those with POCUS vs. without ultrasound (NUS). Primary endpoint was POCUS utilization. Secondary endpoints were successful aspiration, otolaryngology (ear, nose, and throat [ENT]) consultation, computed tomography (CT) imaging, unscheduled return visits, and length of stay (LOS). The Fisher's exact and t-tests analyzed data. Cohort 1 enrolled 48 patients, vs. 114 patients for cohort 2. Twelve patients in cohort 1 had a POCUS (25%) vs 89 in cohort 2 (78%) (p<0.0001; odds ratio [OR] 0.09 (95% confidence interval [CI] 0.04-0.20). Emergency physician (EP) successful aspiration: 89.1% POCUS vs. 24.5% NUS (p<0.0001; OR 25 [95% CI 10-59]). Combined EP/ENT successful aspiration: 99.0% POCUS vs. 80.3% NUS (p<0.0001; OR 24 [95% CI 3-193]). ENT consultation:12.9% POCUS vs. 65.6% NUS (p<0.0001; OR 0.07 [95% CI 0.03-0.17]). CT usage: 23.8% POCUS vs. 37.7% NUS (p=0.07; OR 0.51 [95% CI 0.25-1.02]). Return visits: 3.96% POCUS vs. 18.0% NUS (p=0.004; OR 0.18 [95% CI 0.05-0.61]). POCUS use has increased for PTA treatment, improves aspiration, and decreases consultations, CTs, return visits, and LOS.

Diagnosis and Treatment for Peritonsillar Abscess

Diagnosis and Treatment for Peritonsillar Abscess

ТАКТИКА ЛЕЧЕНИЯ ПАЦИЕНТА С ПЕРИТОНСИЛЛЯРНЫМ АБСЦЕССОМ

The aim of this study was retrospective analysis of indications to hot tonsillectomy, its effectiveness and safety. Peritonsillar abscess (PTA) is one of the most common complications of acute tonsillitis and the cause of emergency laryngological counselling. In some cases, it is necessary to perform hot tonsillectomy. Material and Methods: In between 2018-2019, 32 patients (aged between 18 to 55 years old) with an initial diagnosis of peritonsillar abscess were admitted. Among them, 18 were women and 14 were men. All underwent hot tonsillectomy. Results: Most of the patients were between 19 - 50 years old. The most common symptoms were pain in the throat, trismus and dysphagia. In all cases incision of an abscess was made, in 10 patients purulent discharge was present. In all patients there was no relief of symptoms after in-cision and antibiotic therapy. In 19 cases without drainage after initial incision, pus was drained after tonsillectomy. In the remaining 13 cases there were additional reservoirs of pus, which were drained after surgery in 7 patients. In 9 patients there was more than one localization of an abscess. There were no problems with intubation and no complications in the early and late postoperative periods occurred. The average time of stay in hospital was 10 days. Conclusion: Lack of improvement after initial treatment of PTA is an indication to hot tonsillectomy. This procedure is not connected with an increased risk of complications. Evacuation of purulent content does not exclude presence of another abscess, unusual localization or parapharyngeal space abscess.

Assessment of the utility of ultrasonography and microbiology in the treatment of peritonsillar abscess in children

Introduction. Peritonsillar abscess is the most common deep neck and head space infection. It mostly occurs in young adults and teenagers, usually during the infectious season; at the turn of November and December as well as April and May. The peak incidence coincides with the highest incidence of streptococcal pharyngitis. Aim. A clinical analysis was performed in patients with peritonsillar abscess symptoms to determine the role of ultrasound imaging as a diagnostic tool confirming this condition. Material and methods. A retrospective, non-randomised study conducted in a group of 20 patients aged between 1 and 17 years, who were hospitalised due to peritonsillar abscess or infiltration in the Department of Paediatric Otolaryngology. Ultrasonography of the neck was performed in all patients in the study group to assess the presence of a fluid reservoir on the symptomatic side. Results. Ultrasound imaging revealed the presence of fluid indicative of abscess in 12 cases. Incision and puncture were performed in all these patients. Purulent content was obtained in 11 cases. Conclusions. Ultrasound was found useful in detecting the presence of an abscess and differentiating between peritonsillar infiltration and abscess.