title: Involvement of minor salivary glands in the pathogenesis of peritonsillar abscess.
abstract: OBJECTIVE
  To study the relationship between peritonsillar abscess (PTA) and minor salivary glands surrounding the palatine tonsils.
  
  
  METHODS
  Prospective population-based study.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Prospective study including 41 patients with PTA and 6 patients with a neck abscess. Amylase levels of the pus and serum were measured and compared between the 2 groups. Clinical data regarding hospitalization length and recurrence rate were also collected.
  
  
  RESULTS
  Of the 41 patients with PTA, 7 suffered from recurrent PTA. Average level of amylase in the pus of the PTA group was 3841 U/L versus 7.7 U/L in the neck abscess group (P < .001; median, 62 vs 9.5). Serum amylase was higher in the PTA group (49.3 U/L vs 37.3 U/L; P = .008). There were no recurrences in PTA patients with amylase greater than 65 U/dL in the pus in 0 of 20 (0%) versus 7 of 21 (33%) for amylase lower than 65 U/L (P = .01).
  
  
  CONCLUSIONS
  High amylase in the pus lends further support for involvement of minor salivary glands. However, high recurrence rates related to low amylase in the pus imply an additional pathogenesis possibly related to tonsillar infection. It is possible that both minor salivary glands as well as tonsillar infection play a role in the pathogenesis of peritonsillar infections.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Soroka University Medical Center, Beer-Sheva, Israel. sabriel@clalit.org.il
authors.forename: Sabri
authors.initials: S
authors.lastname: El-Saied
authors.forename: Marc
authors.initials: M
authors.lastname: Puterman
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Kaplan
authors.forename: Merav
authors.initials: M
authors.lastname: Cohen-Lahav
authors.forename: Ben-Zion
authors.initials: BZ
authors.lastname: Joshua
mesh_terms: D000038:Abscess / Q000503:physiopathology; D000681:Amylases / Q000097:blood*; D006801:Humans; D007902:Length of Stay; D009333:Neck; D000039:Peritonsillar Abscess / Q000503:physiopathology*; D011446:Prospective Studies; D012008:Recurrence; D012470:Salivary Glands, Minor / Q000503:physiopathology*; D013492:Suppuration / Q000097:blood
chemical_list: D000681:Amylases