Peritonsillar abscesses and their management - Is abscess cleavage only the transition to tonsillectomy or a permanent solution?

Introduction  The peritonsillar abscess (PTA) is the most common throat infection treated as an inpatient. Abscess relief is achieved by cleavage or abscess tonsillectomy. The aim of this study was to evaluate the management of PTA. Furthermore, complications as well as rates of tonsillitis and pharyngitis and resulting work absenteeism were recorded. 

Methods  In this retrospective study, a total of 821 patients who underwent either abscess cleavage or tonsillectomy (unilateral or bilateral) in the past 10 years were evaluated by chart review. All patients were interviewed by postal questionnaires regarding further course, necessary interventions and necessary time off work.

Results   Of the patients who received abscess cleavage, 12% underwent tonsillectomy during the same inpatient stay. Only 3% underwent tonsillectomy during the interval. 0.7% developed ipsilateral PTA again. None of the patients had a contralateral PTA. Over 6 AB recurrent acute tonsillitis (RAT) did not present in any of the 821 patients surveyed.

Summary  Abscess cleavage is a sufficient therapy of acute PTA in the clear majority of patients. The clinical pictures of PTA and RAT should be considered completely separately. The risk of ipsi- or contralateral recurrence of PTA is very low. Tonsillectomy is recommended bilaterally only when indicated by guidelines for more than 6 AB-requiring tonsillitis. Complications such as frequent absences from work due to pharyngitis or postoperative bleeding occurred only in the group of tonsillectomized patients.

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Artikel online veröffentlicht:
24. Mai 2022