PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 9 September 2007
Clinical analyses of 103 Patients with Peritonsillar Abscess
Hisao Amatsu, Tetsushi Sakashita, Hiroyoshi Iguchi,
Makoto Kusuki, Aki Nakamura and Hideo Yamane
(Osaka City University Graduate School of Medicine)
Masaji Kubo and Akiyoshi Mori
(Minami-Osaka General Hospital)
One hundred three patients with peritonsillar abscess treated between January 2001 and June 2005 were clinically analysed. Seventy-four patients were male and 29 were female. The male to female ratio was 2.5:1. Patient ages ranged from 10 to 76 years old. The average age was 32.4 years old. Fourty nine patients were affected in the right side, and 54 in the left side. Sixty-four of 103 patients were referred to us by other doctors. The local findings deteriorated during the course of treatment in 4 of 103 patients are these four patients developed recurrent peritonsillar abscess. Only 2 patients were diabetic.
All patients were treated with a peritonsillar incision and retropharyngeal incision if retropharyngeal abscess was seen, and at the same time antibiotics were administered intravenously. The most common etiological bacteria was Genus Streptococcus viridans seen in 32 patients, i.e. 33% of 97 patients examined. The second most common was Streptococcus pyogenes seen in 18 patient.
Deep neck infection due to peritonsillar abscess was seen in 8 patients, that is, 8% of this series. Of these 8 patients, all but one were over 40 years old. Four patients had cellulitis and the other 3 had an abscess in the retrophalyngeal space. The former were incised independently from the peritonsillar incision, and the latter were incised from the peritonsillar to retropharyngeal region. Another patient had cellulitis in the parapharyngeal space and was cured with a peritonsillar incision and intravenous antibiotics alone without an external skin incision. This finding was considered an indication that peritonsillar abscess should be correctly treated before deterioration of deep neck infection, especially in patients over 40 years old.
Key words : peritonsillar abscess, peritonsillar incision, deep neck infection