Author's reply to letter-to-the-editor

We welcome the opportunity to continue the discussion and to clarify issues you raised in your letter. You will find enclosed a point-by-point response to your comments. Please note that all of these points are already discussed in the "discussion" section of our article "Comparison of needle aspiration versus incision and drainage under local anaesthesia for the initial treatment of peritonsillar abscess". Regarding the retrospective design of our study, we think that the length of hospital stay was the best criterion to be used as primary outcome because it is a clinical endpoint and a composite criterion, reflecting the global improvement of the patient. Our study included PTA patients aged under 15 because the management of peritonsillar abscess in children follows specific guidelines and requires specific care, and due to evident issues of understanding, compliance and pain handling, incision and drainage under local anaesthesia is not routinely used in younger children. We fully agree that this subject remains an area of debate and we are perfectly aware that due to methodological limitations and especially the retrospective design, the level of evidence of our study is not sufficient to draw firm conclusions on the superiority of one technique on the other. At this day, only low-quality evidence studies have been published on this subject and the debate remains opened to determine whether needle aspiration or incision and drainage is the most safe and effective technique in treating peritonsillar abscess.