An evidence-based review of the treatment of peritonsillar abscess.
OBJECTIVE
Peritonsillar abscess (PTA) is commonly seen but still controversial. We performed an evidence-based review to answer 3 questions: Are steroids beneficial? Which is the best technique for acute surgical management? When is tonsillectomy indicated?


METHODS
We performed a MEDLINE search of the published literature using appropriate search terms to identify pertinent articles, which were reviewed and graded according to the evidence quality.


RESULTS
Forty-two articles were analyzed. There are no published studies on steroids in PTA. There were 5 level I clinical studies on surgical technique, which indicated that needle aspiration, incision and drainage, and quinsy tonsillectomy are all effective for initial management. The overall PTA recurrence rate is 10% to 15%.


CONCLUSIONS
Overall, grade C evidence indicates that several methods of initial surgical drainage are equally effective, and the recurrence rate is low. The literature does not specifically address different treatments for children and adults.
Johnson
Romaine F
RF
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
Stewart
Michael G
MG
Wright
Crystal C
CC
D004322:Drainage; D019317:Evidence-Based Medicine; D006801:Humans; D000039:Peritonsillar Abscess / Q000188:drug therapy / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D014068:Tonsillectomy; D016896:Treatment Outcome