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Recurrent peritonsillar abscesses are uncommon in children, with only 7% experiencing recurrence after incision and drainage. This suggests reevaluating tonsillectomy indications for pediatric peritonsillar abscesses.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Diseases
Background:
- Peritonsillar abscess (PTA) is a common complication of tonsillitis in children.
- Tonsillectomy is often considered for PTA, but its necessity in pediatric cases is debated.
- Recurrence rates in pediatric PTAs are not well-established.
Purpose of the Study:
- To determine the recurrence rate of peritonsillar abscesses in children treated non-surgically.
- To evaluate the long-term outcomes of pediatric peritonsillar abscesses.
- To inform the decision-making process regarding tonsillectomy for pediatric PTAs.
Main Methods:
- Retrospective follow-up study of 41 children with peritonsillar abscesses (1970-1980).
- Focus on 29 patients treated with incision and drainage only.
- Follow-up period ranged from 6 months to 10 years.
Main Results:
- Only 7% (2/29) of patients experienced recurrent peritonsillar abscesses.
- An additional 7% (2/29) had recurrent tonsillitis without abscess formation.
- Children with a prior history of tonsillitis were more likely to experience recurrence.
Conclusions:
- The low recurrence rate (7%) suggests that tonsillectomy may not be routinely indicated for pediatric peritonsillar abscesses.
- Tonsillectomy should be considered for children with a history of documented tonsillitis or complications (e.g., neck abscess, airway compromise).
- Further reevaluation of tonsillectomy indications for pediatric peritonsillar abscesses is warranted.
Abstract:
A follow-up retrospective study was performed on 41 children who presented with peritonsillar abscesses from 1970-1980. The ages ranged from 3 to 16 years, with the mean age of 10 years. There were 26 females and 15 males. The abscesses were predominantly left-sided (28 vs. 13 right-sided) and the mean duration of symptoms was 3 days. Of the patients, 39% had been treated with antibiotics prior to the abscess development. Only 15% of the patients had a documented past history of exudative tonsillitis. Of the 41, 1 patient was lost to follow-up, and 11 underwent tonsillectomy for the abscess. Thus, 29 patients were reviewed who received no surgical therapy for their peritonsillar abscess other than incision and drainage. These patients were contacted for an interval history with a period of follow-up ranging from 6 months to 10 years. Only 2 of the 29 patients (7%) had recurrent abscesses. Two other patients (7%) had further recurrent bouts of exudative tonsillitis but not abscesses. These 4 children were in an initial group of 6 who had a prior history of documented tonsillitis. The incidence of recurrent peritonsillar abscesses reported in the literature has ranged from 7.6 to 16% in series which were comprised mainly of adults. The low incidence of recurrent abscesses (7%) in this series would indicate a need to reevaluate the indication for tonsillectomy for peritonsillar abscess in the pediatric age group. The authors recommend that tonsillectomy be performed in those children who present with a previous history of documented tonsillitis or suffer a complication at the time of the first abscess (neck abscess or airway compromise).