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Related Concept Videos

Tonsillitis II: Management01:26

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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
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Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis.

Alexios Tsikopoulos1, Athanasios Fountarlis2, Konstantinos Tsikopoulos3

  • 11st Department of Otorhinolaryngology-Head and Neck Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 546 21, Thessaloniki, Greece. alextsikop@yahoo.gr.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|February 16, 2022
PubMed
Summary

Immediate tonsillectomy for peritonsillar abscess (quinsy) is safe, offering symptom relief without increased bleeding risk compared to delayed surgery. Interval tonsillectomy, however, resulted in longer hospital stays.

Keywords:
Meta-analysisPeritonsillar abscessQuinsySystematic reviewTonsillectomyTonsillitis

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Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Surgical Outcomes Research

Background:

  • Peritonsillar abscess (quinsy) is a frequent complication of acute tonsillitis.
  • Optimal treatment strategies for quinsy remain debated.
  • Comparing immediate and interval tonsillectomy is crucial for clinical decision-making.

Purpose of the Study:

  • To compare the clinical outcomes of immediate versus interval tonsillectomy for peritonsillar abscess.
  • To evaluate postoperative hemorrhage rates as the primary outcome.
  • To assess secondary outcomes including operative time, blood loss, pain, and hospital stay.

Main Methods:

  • A systematic search of PubMed, Scopus, and Cochrane CENTRAL databases was conducted.
  • Included were comparative studies on immediate and interval tonsillectomy outcomes.
  • A random-effects meta-analysis of six trials (265 cases) was performed, with quality assessment using Cochrane risk of bias and ROBINS-I tools.

Main Results:

  • No significant difference in postoperative hemorrhage rates between immediate and interval tonsillectomy (OR = 1.26; p = 0.77).
  • Interval tonsillectomy was associated with a significantly longer hospital stay (SMD = -0.78; p = 0.01).
  • No significant differences were found in operative time (SMD = 1.10; p = 0.08) or intraoperative blood loss (SMD = 0.04; p = 0.88).

Conclusions:

  • Quinsy tonsillectomy is a safe and effective treatment for peritonsillar abscess, ensuring abscess drainage and symptom relief.
  • Immediate tonsillectomy does not increase the risk of postoperative hemorrhage compared to interval tonsillectomy.
  • Interval tonsillectomy may lead to prolonged hospital stays, suggesting potential benefits of immediate surgical intervention.