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Peritonsillar abscess in children and its indication for tonsillectomy
M Wolf1, J Kronenberg, A Kessler
1Department of Otorhinolaryngology, Sheba-Medical-Center, Tel-Hashomer, Israel.
Insights
A single peritonsillar abscess (PTA) event in children does not necessitate a tonsillectomy. Recurrence rates for PTA or tonsillitis were similar regardless of prior tonsillitis history or treatment method.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
Background:
- Peritonsillar abscess (PTA) is a common complication of tonsillitis in children.
- The decision for tonsillectomy after PTA is often debated, particularly regarding recurrence risk.
Purpose of the Study:
- To evaluate the recurrence rate of peritonsillar abscess (PTA) and tonsillitis in pediatric patients.
- To determine if a history of recurrent tonsillitis or the treatment of an acute PTA influences future occurrences.
Main Methods:
- Retrospective review of 38 pediatric patients (aged 1-15 years) treated for PTA between 1976 and 1986.
- Patients were categorized based on prior tonsillitis history (T+ vs. T-).
- Treatment modalities included surgical drainage, spontaneous rupture, needle aspiration, and medication alone.
Main Results:
- No significant difference in PTA or tonsillitis recurrence rates was observed between patients with (T+) and without (T-) a history of recurrent tonsillitis.
- The chosen treatment method for the acute PTA episode did not impact recurrence rates.
Conclusions:
- A single episode of peritonsillar abscess (PTA) in pediatric patients should not be considered an automatic indication for tonsillectomy.
- Tonsillectomy decisions should consider a broader clinical picture beyond a single PTA event.
Abstract:
38 children aged 1-15 years treated for peritonsillar abscess (PTA) between 1976 and 1986 have been reviewed. The patients were divided into those with a history of recurrent tonsillitis prior to developing PTA (T+) (10 patients = 26.3%) and those without such history (T-) (28 patients = 73.4%). 19 patients were surgically drained, 2 abscesses ruptured spontaneously, 2 patients were treated by repeated needle aspirations and 15 patients were treated by medication only. Neither the pre-PTA history (T+ versus T-) nor the mode of treatment during the acute event showed any significant differences in comparing the recurrency rate of PTA or tonsillitis. Therefore, it seems that a single event of PTA among pediatric population should not be considered an indication for tonsillectomy.