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J Laryngol Otol 2021 Apr 29:1-5. Epub 2021 Apr 29.

Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK.

Background: The impact of coronavirus disease 2019 on healthcare has led to rapid changes in otolaryngology service provisions. As such, new standard operating procedures for the management of suspected tonsillitis or quinsy were implemented in our centre.

Methods: A retrospective audit was performed of acute referrals to ENT of patients with suspected tonsillitis, peritonsillar cellulitis or quinsy, during the 10 weeks before (group 1) and 10 weeks after (group 2) implementation of the new standard operating procedures. Read More

Auris Nasus Larynx 2021 Apr 24. Epub 2021 Apr 24.

Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Germany, Waldstrasse 1, 91054 Erlangen, Germany.

Objective: To identify the appropriate treatment in the tonsillar region's infections, a distinction between tonsillitis with or without abscess formation is essential. Ultrasound proved to be a valuable method in identifying abscess formation in the head and neck region. However, no report described the assessment of the tonsil region. Read More

Int J Pediatr Otorhinolaryngol 2021 May 28;144:110694. Epub 2021 Mar 28.

Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, 20520, Turku, Finland. Electronic address:

Purpose: Pediatric deep neck space infection (DNI) is a relatively rare but potentially life-threatening condition and requires prompt and accurate management. This study retrospectively reviews our experience in a tertiary referral hospital from 2004 to 2019.

Methods: Systematic data collection from medical records using ICD10 codes between 2004 and 2019. Read More

Vestn Otorinolaringol 2021 ;86(1):41-45

Rostov State Medical University, Rostov-on-Don, Russia.

The Aim Of The Study: Was to study the changes in the small salivary glands in chronic tonsillitis and paratonsillar abscess in children. A histological examination of the palatine tonsils of 22 children aged 5 to 14 years old who had a paratonsillar abscess and 18 children suffering from chronic tonsillitis was carried out. Fragments of small salivary glands, located both superficially, in the mucous membrane between the stratified squamous non-keratinizing epithelium and the lymphoid tissue of the palatine tonsils, and between the muscles of the amygdala were found in 42 of the 80 (52. Read More

Indian J Otolaryngol Head Neck Surg 2021 Mar 10:1-3. Epub 2021 Mar 10.

Department of ENT-HNS, Saveetha Medical College and Hospital, No. 1, Saveetha Nagar, Thandalam, Chennai, 602105 Tamilnadu India.

Peritonsillar abscess is a known complication of tonsillitis. The patient usually presents with typical symptoms of odynophagia, fever and difficulty in mouth opening. The diagnosis is established by clinical examination that commonly revealed unilateral peritonsillar swelling. Read More

Int J Environ Res Public Health 2021 02 17;18(4). Epub 2021 Feb 17.

Department of Immunochemistry Diagnostics, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, E. Benese 1128/13, 305 99 Pilsen, Czech Republic.

Tonsillectomy is a routine surgery in otorhinolaryngology and the occurrence of postoperative bleeding is not a rare complication. The aim of this retrospective, observational, analytic, cohort study is to compare the incidence of this complication for the most common indications. A group of patients indicated for tonsillectomies for peritonsillar abscess (group I) was compared to a group of patients indicated for chronic and recurrent tonsillitis (group II). Read More

J Laryngol Otol 2021 Mar 3:1-5. Epub 2021 Mar 3.

Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Objectives: This study examined the uptake of ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines at our tertiary centre, and assessed perceived barriers to uptake.

Methods: A retrospective case series of tonsillitis and quinsy patients was analysed in two arms: before and after the introduction of new ENT UK management guidelines. A survey assessed perceptions and practice differences between ENT and emergency department doctors. Read More

Ann R Coll Surg Engl 2021 Mar;103(3):208-217

The Rotherham Foundation Trust, Moorgate Road, Rotherham.

Introduction: Tonsillectomy is a common surgical procedure performed chiefly for recurrent tonsillitis. The Scottish Intercollegiate Guidance Network (SIGN) introduced guidelines in 1998 to improve patient selection for tonsillectomy and reduce the potential harm to patients from surgical complications such as haemorrhage. Since the introduction of the guidance, the number of admissions for tonsillitis and its complications has increased. Read More

J Laryngol Otol 2021 Feb 22;135(2):117-124. Epub 2021 Feb 22.

Department of Otorhinolaryngology - Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK.

Background: Coronavirus disease 2019 imposed dramatic changes on ENT service delivery. Pre-pandemic, such changes would have been considered potentially unsafe. This study outlines the impact of lockdown on the incidence and management of ENT emergencies at a large UK centre. Read More

J Laryngol Otol 2021 Feb 18;135(2):176-178. Epub 2021 Feb 18.

Department of Ear, Nose and Throat Surgery, Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.

Background: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage.

Issue: Inexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment. Read More

J Laryngol Otol 2021 Mar 17;135(3):191-195. Epub 2021 Feb 17.

Department of ENT, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Objectives: The global pandemic of coronavirus disease 2019 has necessitated changes to 'usual' ways of practice in otolaryngology, with a view towards out-patient or ambulatory management of appropriate conditions. This paper reviews the available evidence for out-patient management of three of the most common causes for emergency referral to the otolaryngology team: tonsillitis, peri-tonsillar abscess and epistaxis.

Methods: A literature review was performed, searching all available online databases and resources. Read More

Am J Otolaryngol 2021 Jul-Aug;42(4):102954. Epub 2021 Feb 5.

Western Michigan University, Homer Stryker M.D. School of Medicine, 300 Portage Street, Kalamazoo, MI 49007, United States of America. Electronic address:

Purpose: Compare the use of medical therapy alone (MTA) with surgical therapy (ST) for the empiric treatment of peritonsillar abscess (PTA).

Materials And Methods: A consecutive cohort of patients treated for PTA at our institution from May 2013 to February 2019 was analyzed. Demographics, disease characteristics, management strategies, and treatment outcomes were compared between treatment groups. Read More

Swiss Med Wkly 2021 Jan 20;151:w20404. Epub 2021 Jan 20.

Universitäres Zentrum für Hausarztmedizin beider Basel, Basel, Switzerland.

Aims: The Centor criteria and the FeverPAIN score are recommended for guiding antibiotic prescription for tonsillitis, but they are not validated for this purpose. We aimed to identify risk factors for peritonsillar abscess in group A haemolytic streptococcus-negative tonsillitis and to test the performance of clinical scores and laboratory tests.

Methods: In a retrospective case-control study at two regional hospitals from January 2015 to June 2018, we identified all cases of peritonsillar abscess and used propensity score matching utilising age and gender to select two controls per case from all patients who had a rapid group A haemolytic streptococcus antigen test in the emergency department. Read More

J Laryngol Otol 2021 Jan 22;135(1):64-69. Epub 2021 Jan 22.

Department of Infectious Diseases, Södra Älvsborg Hospital, Borås, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden.

Objective: This study aimed to compare antibiotic treatment with clindamycin versus penicillin V or G in terms of time to recovery and recurrence in patients with peritonsillar infection, including both peritonsillar cellulitis and peritonsillar abscess.

Method: This retrospective cohort study examined the records of 296 patients diagnosed with peritonsillar infection. Based on the ENT doctor's choice of antibiotics, patients were divided into clindamycin and penicillin groups. Read More

Vestn Otorinolaringol 2020 ;85(6):90-99

Moscow Regional Research and Clinical Institute (MONIKI), Moskow, Russia.

Acute tonsillopharyngitis is one of the most frequent reasons for visiting a doctor and prescribing inappropriate antibiotic therapy (ABT). There are several reasons for this - from the difficulties of etiological diagnosis and the development of relapses and possible severe complications to the personal attitude of doctors and patients to the choice of treatment. At the same time, the issue of antibiotic resistance and other aspects associated with the prescription of ABT is one of the most important problems of modern healthcare worldwide. Read More

Biomed Phys Eng Express 2020 09 8;6(5):055003. Epub 2020 Sep 8.

Department of Otolaryngology, Head and Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, 6608550 Higashinaniwachou 2-17-77 Hyogo Prefecture, Japan.

Objective: To investigate the association between subjective pain intensity and objective parameters obtained from two autonomic function tests in a longitudinal study targeting acute pain model in otolaryngology-head and neck region: pupillary light reflex (PLR) and heart rate variability (HRV).

Approach: We enrolled 35 patients with acute otolaryngology-head and neck region inflammatory disorders at pre-treatment stage. The acute inflammatory disorders were defined as acute tonsillitis, peritonsillar abscess, acute epiglottitis, acute sinusitis, and deep neck space abscess. Read More

Ear Nose Throat J 2021 Jan 12:145561320984996. Epub 2021 Jan 12.

Department of Otolaryngology-Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA.

Objectives: Peritonsillar abscess (PTA) is the most common deep neck space infection and a frequent cause for otolaryngology consultation. Patients often undergo computed tomography (CT) scan for confirmation in addition to physical examination. Our aims were to determine whether patients unnecessarily undergo CT scans in the emergency department (ED) when presenting with sore throat and identify physical examination characteristics that predict PTA. Read More

Eur Arch Otorhinolaryngol 2021 Jul 9;278(7):2613-2618. Epub 2021 Jan 9.

Mid and South Essex Hospital Services NHS Trust, Chelmsford, UK.

Objectives: Guidance set out by Scottish Intercollegiate Guidelines Network (SIGN) sought to restrict the frequency of elective tonsillectomy in reaction to the recognised and substantial risks of the procedure, namely pain and bleeding. With stricter criteria in place before a patient can undergo tonsillectomy, patients must endure more episodes of tonsillitis than was previously the case. The cost of managing tonsillitis and its complications as an inpatient is substantial to the NHS and also to the economy as a whole in missed work days. Read More

J Laryngol Otol 2021 Jan 7;135(1):70-73. Epub 2021 Jan 7.

Department of Otorhinolaryngology - Head and Neck Surgery, Royal Derby Hospital, Derby, UK.

Objectives: This study sought to determine the conditions that still present to ENT despite government advice to avoid unnecessary travel. It also assessed the impact of social distancing on pathologies presenting to ENT and reviewed the usefulness of telephone consultations in semi-urgent presentations.

Method: A retrospective review was conducted of 97 instances of patient care carried out in the rapid access ENT clinic at a large district general hospital. Read More

Praxis (Bern 1994) 2020 ;109(16):1223

FMH Innere Medizin und Infektiologie, Innere Medizin und Diagnostik, Spital Zofingen.

Clin Otolaryngol 2020 Dec 2. Epub 2020 Dec 2.

Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.

Objectives: To report changes in practice brought about by COVID-19 and the implementation of new guidelines for the management of tonsillitis and peritonsillar abscess (PTA), and to explore factors relating to unscheduled re-presentations for patients discharged from the emergency department (ED).

Design: Prospective multicentre national audit over 12 weeks from 6th April 2020.

Setting: UK secondary care ENT departments. Read More

Orv Hetil 2020 11 1;161(44):1877-1883. Epub 2020 Nov 1.

1 Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Szeged, Tisza Lajos krt. 111., 6725.

Összefoglaló. Bevezetés és célkitűzés: A peritonsillaris tályog a leggyakoribb mély nyaki infekció. Olyan fül-orr-gégészeti kórkép, amely megfelelő kezelés nélkül életveszélyes szövődményekkel járhat. Read More

Pediatr Emerg Med Pract 2020 Nov 2;17(11):1-24. Epub 2020 Nov 2.

Assistant Professor of Pediatrics and Emergency Medicine, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Head and neck infections can spread to nearby structures, compromising the airway and progressing to life-threatening events. Pediatric head and neck infections can be difficult to recognize; emergency clinicians must know the signs and symptoms of head and neck infections for early diagnosis and urgent management in order to prevent complications and decrease hospitalization rates. This issue reviews presenting signs and symptoms of pediatric head and neck infections, discusses when diagnostic studies are indicated, and offers evidence-based recommendations for management. Read More

Cureus 2020 Sep 10;12(9):e10367. Epub 2020 Sep 10.

Infectious Diseases, University of Louisville School of Medicine, Louisville, USA.

Spontaneous tonsillar hemorrhage is defined as continuous bleeding for more than one hour, or more than 250 mL of blood loss regardless of the duration of bleeding. It is associated with various pathologic conditions, including acute or chronic tonsillitis, peritonsillar or parapharyngeal abscess, infectious mononucleosis, carotid aneurysm or pseudoaneurysm, and tonsil cancer. It is a rare complication with very limited data reported in the literature. Read More

BMJ Case Rep 2020 Oct 10;13(10). Epub 2020 Oct 10.

General Surgery Department, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal.

Parathyroid cysts are rare lesions of the cervical region and less frequently of the mediastinum. They occur mostly in women and are usually asymptomatic. They generally occur in the fourth and fifth decades of life and mainly are non-functioning. Read More

Clin Otolaryngol 2021 01 20;46(1):229-233. Epub 2020 Oct 20.

Arrowe Park Hospital, Wirral, UK.

Objectives: Our primary aim was to validate the Liverpool Peritonsillar abscess Score (LPS) externally in a new patient cohort. Our secondary aim was to modify the LPS in the light of the COVID-19 pandemic to produce a no-examination variant for use in this instance.

Design: Prospective multicentre external validation study. Read More

J Laryngol Otol 2020 Sep 28:1-4. Epub 2020 Sep 28.

Department of ENT, New Cross Hospital, Wolverhampton, UK.

Objective: As the novel coronavirus disease 2019 changed patient presentation, this study aimed to prospectively identify these changes in a single ENT centre.

Design: A seven-week prospective case series was conducted of urgently referred patients from primary care and accident and emergency department.

Results: There was a total of 133 referrals. Read More

Am J Otolaryngol 2020 Nov - Dec;41(6):102716. Epub 2020 Sep 10.

Department of Otolaryngology/ENT, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd., Wilmington, DE 19803, USA; Thomas Jefferson University, 130 S. 9th St., Philadelphia, PA 19107, USA. Electronic address:

Context: To describe this new clinical entity, diagnosis, and potential management of pediatric intratonsillar/peritonsillar abscesses in children affected by infectious mononucleosis.

Methods: After institutional review board approval, a retrospective chart review of patients who underwent testing for infectious mononucleosis and also had a computed tomography scan of the head and neck was completed. Those who did not have imaging showing the palatine tonsils and those with insufficient testing to diagnose infectious mononucleosis were excluded. Read More

BMJ Case Rep 2020 Sep 7;13(9). Epub 2020 Sep 7.

Otolaryngology-Head and Neck Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia

Transoral drainage of peritonsillar abscess during the COVID-19 pandemic is a high-risk procedure due to potential aerosolisation of SARS-CoV-2. This case describes conservative management of peritonsillar abscess in a 21-year-old male with COVID-19. Read More

Vestn Otorinolaringol 2020 ;85(4):35-39

Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n. Read More