Tonsillectomy à chaud for quinsy: revisited

Area of Science:

• Otolaryngology
• Surgical Management
• Infectious Diseases

Background:

• Quinsy (peritonsillar abscess) management traditionally involves incision and drainage followed by delayed tonsillectomy.
• The optimal timing for tonsillectomy in patients with quinsy requires further investigation to improve patient outcomes and reduce healthcare burdens.

Purpose of the Study:

• To evaluate the safety and efficacy of tonsillectomy à chaud (immediate tonsillectomy) as an alternative to interval tonsillectomy in patients with quinsy.
• To assess the impact of tonsillectomy à chaud on patient morbidity and healthcare costs.

Main Methods:

• A prospective study involving 16 patients admitted with quinsy and an indication for tonsillectomy over 12 months.
• Twelve patients underwent tonsillectomy à chaud within 30 hours of acute admission, following initial management with incision/drainage or needle aspiration, rehydration, analgesia, and antibiotics.

Main Results:

• Tonsillectomy à chaud was performed in 12 out of 16 eligible patients, with no reported complications.
• Intra-operative pus detection was high despite initial drainage, and peritonsillitis was more common than peritonsillar abscess in this cohort.
• The immediate tonsillectomy approach successfully avoided further hospitalizations, reducing patient morbidity and associated costs.

Conclusions:

• Tonsillectomy à chaud is a justifiable and effective alternative to interval tonsillectomy for selected patients with quinsy.
• This immediate surgical approach offers benefits in terms of reduced morbidity and cost-effectiveness when resources permit.