Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T04:31:13.603Z Has data issue: false hasContentIssue false

Risk factors for recurrence of peritonsillar abscess

Published online by Cambridge University Press:  17 November 2014

J H Chung
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
Y C Lee
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
S Y Shin
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
Y G Eun*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
*
Address for correspondence: Dr Young Gyu Eun, Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Fax: 82-2-958-8470 E-mail: [email protected]

Abstract

Background:

Additional high-quality evidence for predictors of peritonsillar abscess recurrence could lead to better-informed treatment decisions regarding tonsillectomy.

Methods:

In this study, 172 patients, who had been diagnosed and treated for peritonsillar abscess, were evaluated at follow up. A retrospective review of medical records and a telephone survey were performed. The clinical characteristics analysed included underlying disease, laboratory findings and computed tomography findings. Cox proportional hazard models were used to identify risk factors for peritonsillar abscess recurrence.

Results:

The recurrence rate of peritonsillar abscess was 13.9 per cent. Univariate analysis indicated that extraperitonsillar spread of the abscess (beyond the peritonsillar area) on computed tomography and a history of recurrent tonsillitis were associated with recurrence. Multivariate analysis also indicated that extraperitonsillar spread (p = 0.007; hazard ratio = 3.399) and recurrent tonsillitis history (p < 0.001; hazard ratio = 11.953) were significant risk factors for recurrence.

Conclusion:

Our results suggest that tonsillectomy may be indicated as a treatment for peritonsillar abscess in patients with a history of recurrent tonsillitis or extraperitonsillar spread on computed tomography.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Johnson, RF, Stewart, MG, Wright, CC. An evidence-based review of the treatment of peritonsillar abscess. Otolaryngol Head Neck Surg 2003;128:332–43CrossRefGoogle ScholarPubMed
2Herzon, FS, Harris, P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope 1995;105:117CrossRefGoogle Scholar
3Petruzzelli, GJ, Johnson, JT. Peritonsillar abscess. Why aggressive management is appropriate. Postgrad Med 1990;88:99100,103–5,108CrossRefGoogle ScholarPubMed
4Marom, T, Cinamon, U, Itskoviz, D, Roth, Y. Changing trends of peritonsillar abscess. Am J Otolaryngol 2010;31:162–7CrossRefGoogle ScholarPubMed
5Powell, J, Wilson, JA. An evidence-based review of peritonsillar abscess. Clin Otolaryngol 2012;37:136–45Google Scholar
6Wolf, M, Even-Chen, I, Talmi, YP, Kronenberg, J. The indication for tonsillectomy in children following peritonsillar abscess. Int J Pediatr Otorhinolaryngol 1995;31:43–6Google Scholar
7Sorensen, JA, Godballe, C, Andersen, NH, Jørgensen, K. Peritonsillar abscess: risk of disease in the remaining tonsil after unilateral tonsillectomy à chaud. J Laryngol Otol 1991;105:442–4Google Scholar
8Raut, VV, Yung, MW. Peritonsillar abscess: the rationale for interval tonsillectomy. Ear Nose Throat J 2000;79:206–9Google Scholar
9Harris, WE. Is a single quinsy an indication for tonsillectomy? Clin Otolaryngol Allied Sci 1991;16:271–3Google Scholar
10Mehanna, HM, Al-Bahnasawi, L, White, A. National audit of the management of peritonsillar abscess. Postgrad Med J 2002;78:545–8CrossRefGoogle Scholar
11Maharaj, D, Rajah, V, Hemsley, S. Management of peritonsillar abscess. J Laryngol Otol 1991;105:743–5CrossRefGoogle ScholarPubMed
12Stringer, SP, Schaefer, SD, Close, LG. A randomized trial for outpatient management of peritonsillar abscess. Arch Otolaryngol Head Neck Surg 1988;114:296–8CrossRefGoogle ScholarPubMed
13Nwe, TT, Singh, B. Management of pain in peritonsillar abscess. J Laryngol Otol 2000;114:765–7Google Scholar
14Paradise, JL, Bluestone, CD, Colborn, DK, Bernard, BS, Rockette, HE, Kurs-Lasky, M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002;110:715CrossRefGoogle ScholarPubMed
15Hoddeson, EK, Gourin, CG. Adult tonsillectomy: current indications and outcomes. Otolaryngol Head Neck Surg 2009;140:1922CrossRefGoogle ScholarPubMed
16Kronenberg, J, Wolf, M, Leventon, G. Peritonsillar abscess: recurrence rate and the indication for tonsillectomy. Am J Otolaryngol 1987;8:82–4CrossRefGoogle ScholarPubMed
17Wolf, M, Kronenberg, J, Kessler, A, Modan, M, Leventon, G. Peritonsillar abscess in children and its indication for tonsillectomy. Int J Pediatr Otorhinolaryngol 1988;16:113–17CrossRefGoogle ScholarPubMed
18Wikstén, J, Hytönen, M, Pitkäranta, A, Blomgren, K. Who ends up having tonsillectomy after peritonsillar infection? Eur Arch Otorhinolaryngol 2012;269:1281–4CrossRefGoogle ScholarPubMed
19Stage, J, Bonding, P. Peritonsillar abscess with parapharyngeal involvement: incidence and treatment. Clin Otolaryngol Allied Sci 1987;12:15CrossRefGoogle ScholarPubMed
20Monobe, H, Suzuki, S, Nakashima, M, Tojima, H, Kaga, K. Peritonsillar abscess with parapharyngeal and retropharyngeal involvement: incidence and intraoral approach. Acta Otolaryngol Suppl 2007;559:91–4CrossRefGoogle Scholar