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Immediate tonsillectomy: indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess

Published online by Cambridge University Press:  20 April 2010

C Page ,
G Chassery ,
P Boute ,
R Obongo  and
V Strunski
C Page*
Affiliation:
ENT and Head and Neck Surgery Department, Amiens University Hospital, Amiens, France Anatomy Department, School of Medicine, ‘Jules Verne’ University, Amiens, France
G Chassery
Affiliation:
ENT and Head and Neck Surgery Department, Amiens University Hospital, Amiens, France
P Boute
Affiliation:
ENT and Head and Neck Surgery Department, Amiens University Hospital, Amiens, France
R Obongo
Affiliation:
ENT and Head and Neck Surgery Department, Amiens University Hospital, Amiens, France
V Strunski
Affiliation:
ENT and Head and Neck Surgery Department, Amiens University Hospital, Amiens, France
*
Address for correspondence: Dr Cyril Page, Centre Hospitalier Nord, Place Victor Pauchet, 80054 Amiens cedex, France. Fax: +33 03 22 66 86 23 E-mail: [email protected]
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Abstract

Objectives:

This study was designed to evaluate the efficacy and morbidity of immediate tonsillectomy used to treat peritonsillar abscess (quinsy) and parapharyngeal abscess.

Subjects and method:

This four-year, retrospective study was based on 31 patients hospitalised in a university hospital ENT and head and neck surgery department for peritonsillar and/or parapharyngeal abscess. All patients underwent immediate, bilateral tonsillectomy. The length of hospital stay, duration of antibiotic therapy, microbiological findings, complications, and the time to complete recovery and oropharyngeal healing were recorded.

Results:

The patients' mean post-tonsillectomy hospital stay was 2.84 days (median: 3 days). No post-operative haemorrhage was observed. All patients were considered to be cured at the day 10 follow-up visit, and complete oropharyngeal healing was observed at the day 21 visit. The duration of antibiotic therapy ranged from 10 to 15 days (mean: 11.5 days; median: 10 days).

Discussion and conclusion:

Immediate tonsillectomy appears to be a safe and effective surgical technique for the management of peritonsillar and parapharyngeal abscess; in particular, it markedly reduces patients' hospital stay (when performed early in the course of the disease) and duration of antibiotic therapy. Immediate tonsillectomy has become the first-line treatment for parapharyngeal abscess and several types of peritonsillar abscess in our department.

Keywords

TonsilsPeritonsillar AbscessPharynxTonsillectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 10 , October 2010 , pp. 1085 - 1090
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Page, C, Biet, A, Zaatar, R, Strunski, V. Parapharyngeal abscess: diagnosis and treatment. Eur Arch Otorhinolaryngol 2008;265:681–6CrossRefGoogle ScholarPubMed
2Page, C, Peltier, J, Medard, C, Celebi, Z, Schmit, JL, Strunski, V. Peritonsillar abscesses (quinsy) [in French]. Ann Otolaryngol Chir Cervicofac 2007;124:9–15CrossRefGoogle Scholar
3Alaani, A, Griffiths, H, Minhas, SS, Olliff, J, Lee, AB. Parapharyngeal abscess: diagnosis, complications and management in adults. Eur Arch Otorhinolaryngol 2005;262:345–50CrossRefGoogle ScholarPubMed
4Brook, I. Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg 2004;62:1545–50CrossRefGoogle ScholarPubMed
5Sichel, JY, Dano, I, Hocwald, E, Biron, A, Eliashar, R. Non surgical management of parapharyngeal space infections: a prospective study. Laryngoscope 2002;112:906–10CrossRefGoogle Scholar
6Kieff, DA, Bhattacharyya, N, Siegel, NS, Salman, SD. Selection of antibiotics after incision and drainage of peritonsillar abscesses. Otolaryngol Head Neck Surg 1999;120:57–61CrossRefGoogle ScholarPubMed
7Ozbek, C, Aygenc, E, Tuna, EU, Selcuk, A, Ozdem, C. Use of steroids in the treatment of peritonsillar abscess. J Laryngol Otol 2004;118:439–42Google Scholar
8Wagner, R, Espitalier, F, Madoz, A, Picherot, G, Bordure, P, Malard, O. Retro- and parapharyngeal abscess in children: predictive factors of medical treatment failure [in French]. Ann Otolaryngol Chir Cervicofac 2009;126:112–19CrossRefGoogle ScholarPubMed
9Fédérici, S, Silva, C, Maréchal, C, Laporte, E, Sévely, A, Grouteau, E et al. Retro- and parapharyngeal infections: toward a standardization of their management [in French]. Arch Pediatr 2009;16:1225–32CrossRefGoogle Scholar
10Pelaz, AC, Allende, AV, Llorente Pendás, JL, Nieto, CS. Conservative treatment of retropharyngeal and parapharyngeal abscess in children. J Craniofac Surg 2009;20:1178–81CrossRefGoogle ScholarPubMed
11Daya, H, Lo, S, Papsin, BC, Zachariasova, A, Murray, H, Pirie, J, Laughlin, S, Blaser, S. Retropharyngeal and parapharyngeal infections in children: the Toronto experience. Int J Pediatr Otorhinolaryngol 2005;69:81–6Google Scholar
12Amar, YG, Manoukian, JJ. Intraoral drainage: recommended as the initial approach for the treatment of parapharyngeal abscesses. Otolaryngol Head Neck Surg 2004;130:676–80CrossRefGoogle ScholarPubMed
13McClay, JE, Murray, AD, Booth, T. Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg 2003;129:1207–12CrossRefGoogle ScholarPubMed
14Berry, S, Pascal, I, Whittet, HB. Tonsillectomy à chaud for quinsy: revisited. Eur Arch Otorhinolaryngol 2008;265:31–3Google Scholar
15Windfuhr, JP, Chen, YS. Immediate abscess tonsillectomy. A safe procedure? Auris Nasus Larynx 2001;28:323–7CrossRefGoogle ScholarPubMed
16Fujimoto, M, Aramaki, H, Takano, S, Otani, Y. Immediate tonsillectomy for peritonsillar abscess. Acta Otolaryngol Suppl 1996;523:252–5Google Scholar
17Suzuki, M, Ueyama, T, Mogi, G. Immediate tonsillectomy for peritonsillar abscess. Auris Nasus Larynx 1999;26:299–304Google Scholar
18Templer, JW, Holinger, LD, Wood, RP 2nd, Tra, NT, DeBlanc, GB. Immediate tonsillectomy for the treatment of peritonsillar abscess. Am J Surg 1977;134:596–8CrossRefGoogle ScholarPubMed
19Lehnerdt, G, Senska, K, Jahnke, K, Fischer, M. Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy. Acta Otolaryngol 2005;125:1312–17Google Scholar
20Giger, R, Landis, BN, Dulguerov, P. Hemorrhage risk after quinsy tonsillectomy. Otolaryngol Head Neck Surg 2005;133:729–34Google Scholar
21Johnson, RF, Stewart, MG, Wright, CC. An evidence-based review of the treatment of peritonsillar abscess. Otolaryngol Head Neck Surg 2003;128:332–43CrossRefGoogle ScholarPubMed