Cranial tonsillotomy for peritonsillar abscess (PTA) – A clinical Assessment

Introduction:

PTA is a common infection of the oropharynx resulting in odynophagia, fever and trismus. Several draining methods are accepted, including needle aspiration (NA), incision and drainage (ID) and abscess tonsillectomy (TAC). Controversy still surrounds the question which surgical technique has the highest success rate. The aim of this study was to evaluate the outcome in patients with a non-complicated PTA who had undergone ID supplemented by a cranial tonsillotomy (IDTT) as first-line treatment.

Materials and methods:

We retrospectively analyzed the charts of 298 patients who had undergone IDTT at our department between 01.01.2015 and 31.12.2017. We determined the pain intensity after surgery on a 10-point visual-analogue-scale, the duration of hospitalization, postoperative hemorrhage rate und recurrence rate. In addition, we examined the necessity of re-opening of the abscess cavity after surgery.

Results:

A re-draining of the abscess cavity became necessary in only one patient. Significant postoperative hemorrhage occurred in 2 patients (0,6%), 5 und 8 days after surgery. The median pain intensity within the first three postoperative days was 2, 1 and 1, respectively. Oral analgesics were not requested in 35,3% or given on-demand in 38,6%. Only 26,1% received regular doses of analgesics. There were 4 patients presenting with a recurrent PTA of the same side (1%). The patients were hospitalized for 2,93 days on average.

Conclusions:

IDTT is a safe surgical concept, associated with great patient comfort. It eliminates the necessity of painful re-draining of the wound cavity while is not followed by a significant amount of PTA-recurrences. In addition, it offers the advantage to exclude a neoplasia by histological examination.

Publication History

Publication Date:
23 April 2019 (online)