Tonsillectomy à chaud for quinsy: revisited.
In a prospective study involving 16 patients over a 12 month period, we determined whether tonsillectomy à chaud is an acceptable alternative to interval tonsillectomy for patients with quinsy. Guidelines for the acute surgical management of quinsy (or peritonsillar abscess) were established following a departmental audit. Sixteen patients were admitted with a quinsy plus an indication for tonsillectomy; 12 were evaluated prospectively. Each was treated either by incision and drainage or needle aspiration, rehydration, analgesia and intravenous antibiotic therapy, followed by a tonsillectomy à chaud (immediate tonsillectomy) within 30 h of the acute admission. Despite initial drainage, a high incidence of pus was detected intra-operatively. A much larger group of patients had peritonsillitis rather than peritonsillar abscess. Of the 16 patients admitted with a quinsy and indication for tonsillectomy over a 12 month period, 12 consented to tonsillectomy à chaud. Aspiration was used to confirm the presence of a quinsy in seven patients (58%), and incision and drainage in the remaining five. There were no complications, and further hospitalisations were avoided thus reducing patient morbidity and costs. We propose that tonsillectomy à chaud remains a justifiable alternative to interval tonsillectomy for such patients when personnel and theatre facilities permit.
Berry
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Department Of Otolaryngology and Head and Neck Surgery, Singleton Hospital, Swansea, UK. DOCSN@aol.com
Pascal
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Whittet
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HB
D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D000039:Peritonsillar Abscess / Q000601:surgery*; D014068:Tonsillectomy; D055815:Young Adult