[Peritonsillar abscess. Emergency tonsillectomy?]

The treatment of peritonsillar abcess is still controversial: quincy tonsillectomy, also called tonsillectomy "à chaud" (TC) or interval tonsillectomy, also known as tonsillectomy "à froid" (TF), several weeks after incision and drainage. Of 105 patients presenting with peritonsilar abscess, 53 had tonsillectomy: 27 TC and 26 TF. For each group the following variables were analyzed: age, location of abscess, bacteriology, duration of surgery, amount of per-operative bleeding, post-operative hemorrhage and complications, and length of hospital stay. The location of the abscess was posterior in 33%, and therefore difficult to drain without tonsillectomy. Significant differences in favor of TC were found for: 1) the amount of per-operative bleeding; 2) the occurrence of post-operative hemorrhage; and 3) the duration of hospital stay. We conclude that TC is a safe procedure without increased risks, with less complications, and with a reduced cost. When surgery is indicated in the treatment of peritonsillar abcess, we advocate TC. From our results and the litterature a decision tree for the management of peritonsillar abcess is presented.