Extension of infection beyond the tonsil results in a peritonsillar abscess and is a frequent emergency presentation in otolaryngology. In many places one episode of peritonsillar abscess is not considered an indication for emergency or interval tonsillectomy and future episodes of tonsillitis and peritonsillar abscesses are therefore not prevented. In this study, the authors have assessed the recurrence rate of peritonsillar abscess in 121 patients, of which 18% had a history of recurrent tonsillitis, 1.7% had a history of diabetes and 4% a history of hypertension. The recurrence rate noted was 13.9 % in comparison to a 5-22% recurrence rate in the literature. Univariate analysis showed that recurrent tonsillitis was associated with recurrence of peritonsillar abscess. The authors performed CT scans on all cases of peritonsillar abscess and interestingly, multivariate analysis showed that spread of infection beyond the tonsillar capsule, lateral or inferior to the superior pharyngeal constrictor muscle as noted on the CT scans, was associated with recurrence of peritonsillar abscess. This particular feature of the study adds an important dimension to the management of peritonsillar abscess in terms of interval tonsillectomy.
Peritonsillar abscess - an indication for tonsillectomy?
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