Predictors of intratonsillar abscess versus peritonsillar abscess in the pediatric patient.

Authors:
Kevin J Kovatch
Kevin J Kovatch
University of Pennsylvania
United States
Josh Smith
Josh Smith
University of Washington
Seattle | United States
Emily L Bellile
Emily L Bellile
University of Michigan School of Public Health
Carl M Truesdale
Carl M Truesdale
Perelman School of Medicine at the University of Pennsylvania
Paul T Hoff
Paul T Hoff
University of Michigan Health System
United States

Int J Pediatr Otorhinolaryngol 2018 Nov 5;114:143-146. Epub 2018 Sep 5.

Michigan Medicine, Department of Otolaryngology, Head & Neck Surgery, Ann Arbor, MI, United States.

Objective: To determine the incidence of intratonsillar abscess (ITA) patients within the population of patients diagnosed with peritonsillar abscess (PTA) and to further characterize the differences in symptomatology and successful treatment strategies between the two groups.

Methods: This study is a retrospective chart review of patients diagnosed with PTA or ITA at our institution from 2000 to 2017. Descriptive and inferential statistics are reported, including univariate and multivariate analyses.

Results: A total of 335 pediatric (<18 years) patients presenting with a PTA or ITA were identified, 31 (9%) of whom were diagnosed with ITA. Patients with ITAs had significantly lower proportions of trismus, otalgia, and dysphagia and were less likely to experience acute progression from their initial symptoms. The ITA group had fewer attempted aspiration and drainage attempts, with those attempts significantly less successful than for the PTA group. Recurrence was uncommon in ITA patients in comparison to PTA patients.

Conclusions: Intratonsillar abscess should be considered in the differential diagnosis for patients presenting with sore throat and concern for a pharyngeal infection or abscess. These patients have a significantly lower proportion of otalgia, trismus, vocal changes, and dysphagia. Given the low success rate of drainage attempts and lower recurrence rate, diagnosing physicians should consider medical management rather than procedural drainage in this patient population.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijporl.2018.08.042DOI Listing
November 2018
8 Reads
1.320 Impact Factor

Publication Analysis

Top Keywords

intratonsillar abscess
8
patients diagnosed
8
peritonsillar abscess
8
study retrospective
4
retrospective chart
4
review patients
4
diagnosed pta
4
groupsmethods study
4
chart review
4
treatment strategies
4
characterize differences
4
pta characterize
4
differences symptomatology
4
symptomatology successful
4
pta ita
4
strategies groupsmethods
4
institution 2000
4
univariate multivariate
4
including univariate
4
multivariate analysesresults
4

Similar Publications