[Ultrasonography for peritonsillar abscess diagnosis: benefits and drawbacks]

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Otolaryngology

Background:

• Peritonsillar abscesses require accurate diagnosis for effective treatment.
• Traditional diagnostic methods may have limitations in certain patient populations or clinical scenarios.

Purpose of the Study:

• To evaluate the diagnostic utility of external and intraoral ultrasound for peritonsillar abscesses.
• To compare ultrasound with multi-slice computed tomography (CT) in diagnosing peritonsillar abscesses.

Main Methods:

• Two clinical cases of peritonsillar abscesses were assessed using neck soft tissue ultrasound.
• External and intraoral ultrasound approaches were employed, with analysis of abscess characteristics, adjacent vasculature, and differential diagnoses.
• Ultrasound findings were implicitly compared to CT scan characteristics.

Main Results:

• Ultrasound successfully identified peritonsillar abscess cavities, their size, and location.
• It effectively excluded the proximity of large or abnormal vessels and aided in differentiating abscesses from tumors or angioedema.
• External ultrasound was well-tolerated and informative but had challenges in determining puncture sites, while intraoral ultrasound offered better localization but was limited by patient trismus and transducer size, especially in children.

Conclusions:

• Both external and intraoral ultrasound are informative for detecting peritonsillar abscesses.
• Ultrasound presents a cheaper, more accessible, faster, and radiation-free alternative to CT scans for diagnosing peritonsillar abscesses, particularly in complex cases.