J H Chung1, Y C Lee1, S Y Shin1, Y G Eun1. 1. Department of Otolaryngology-Head and Neck Surgery,Kyung Hee University School of Medicine,Seoul,Korea.
Abstract
BACKGROUND: Additional high-quality evidence for predictors of peritonsillar abscess recurrence could lead to better-informed treatment decisions regarding tonsillectomy. METHODS: In this study, 172 patients, who had been diagnosed and treated for peritonsillar abscess, were evaluated at follow up. A retrospective review of medical records and a telephone survey were performed. The clinical characteristics analysed included underlying disease, laboratory findings and computed tomography findings. Cox proportional hazard models were used to identify risk factors for peritonsillar abscess recurrence. RESULTS: The recurrence rate of peritonsillar abscess was 13.9 per cent. Univariate analysis indicated that extraperitonsillar spread of the abscess (beyond the peritonsillar area) on computed tomography and a history of recurrent tonsillitis were associated with recurrence. Multivariate analysis also indicated that extraperitonsillar spread (p = 0.007; hazard ratio = 3.399) and recurrent tonsillitis history (p < 0.001; hazard ratio = 11.953) were significant risk factors for recurrence. CONCLUSION: Our results suggest that tonsillectomy may be indicated as a treatment for peritonsillar abscess in patients with a history of recurrent tonsillitis or extraperitonsillar spread on computed tomography.
BACKGROUND: Additional high-quality evidence for predictors of peritonsillar abscess recurrence could lead to better-informed treatment decisions regarding tonsillectomy. METHODS: In this study, 172 patients, who had been diagnosed and treated for peritonsillar abscess, were evaluated at follow up. A retrospective review of medical records and a telephone survey were performed. The clinical characteristics analysed included underlying disease, laboratory findings and computed tomography findings. Cox proportional hazard models were used to identify risk factors for peritonsillar abscess recurrence. RESULTS: The recurrence rate of peritonsillar abscess was 13.9 per cent. Univariate analysis indicated that extraperitonsillar spread of the abscess (beyond the peritonsillar area) on computed tomography and a history of recurrent tonsillitis were associated with recurrence. Multivariate analysis also indicated that extraperitonsillar spread (p = 0.007; hazard ratio = 3.399) and recurrent tonsillitis history (p < 0.001; hazard ratio = 11.953) were significant risk factors for recurrence. CONCLUSION: Our results suggest that tonsillectomy may be indicated as a treatment for peritonsillar abscess in patients with a history of recurrent tonsillitis or extraperitonsillar spread on computed tomography.
Authors: S Ahmed Ali; Kevin J Kovatch; Josh Smith; Emily L Bellile; John E Hanks; Paul T Hoff Journal: Laryngoscope Date: 2018-12-24 Impact factor: 3.325