The role of computed tomography in the management of peritonsillar abscess.
Twenty-four patients who fulfilled the clinical criteria for peritonsillar abscess (PTA) were randomized into two groups over a 6-month period. Group A (n = 13) underwent CT with contrast, whereas group B (n = 11) was managed without radiologic investigation. In group A, CT with contrast enabled differentiation of PTA from peritonsillar cellulitis in all 13 cases (100%) and demonstrated abscesses in 11 patients (85%), thereby allowing drainage at first attempt. Two patients with peritonsillar cellulitis were successfully managed with antibiotics only. In group B, all patients underwent needle aspiration. In seven patients (64%), pus was found after needle aspiration at first attempt and in one patient after needle aspirations at two locations. In three patients (27%), no pus was found after needle aspirations at three different locations. We conclude that CT enhances diagnostic accuracy, obviating unnecessary drainage procedures, and reduces patient morbidity.
Patel
K S
KS
Department of Otolaryngology, King's College Hospital, Denmark Hill, England.
Ahmad
S
S
O'Leary
G
G
Michel
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000000981:diagnostic imaging / Q000188:drug therapy; D003937:Diagnosis, Differential; D004322:Drainage; D006801:Humans; D000039:Peritonsillar Abscess / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D011897:Random Allocation; D013396:Suction; D014057:Tomography, X-Ray Computed; D014069:Tonsillitis / Q000000981:diagnostic imaging / Q000188:drug therapy
D000900:Anti-Bacterial Agents