Artikel
Cranial tonsillotomy for Peritonsillar abscess
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Autoren
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Stavroula Ziogou
- Kliniken Maria Hilf GmbH, Department of Otorhinolaryngology, Moenchengladbach, Germany
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Jochen Windfuhr
- Kliniken Maria Hilf GmbH, Department of Otorhinolaryngology, Moenchengladbach, Germany
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Laura Timm
- Kliniken Maria Hilf GmbH, Department of Otorhinolaryngology, Moenchengladbach, Germany
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Mehregan Nematian-Samani
- Kliniken Maria Hilf GmbH, Department of Otorhinolaryngology, Moenchengladbach, Germany
| Veröffentlicht: | 7. September 2016 |
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Gliederung
Text
Introduction: Peritonsillar abscess (PTA) is the most common deep neck infection. Several draining methods are accepted, including needle aspiration (NA), incision and drainage (ID) and abscesstonsillectomy. Despite decades of experience with each technique a gold standard for the management of PTA still does not exist. This retrospective study aimed to evaluate the outcome in patients with a non-complicated PTA who had undergone ID supplemented by tonsillotomy (IDTT).
Material and methods: We retrospectively analyzed the charts of 73 patients who had undergone IDTT under general anesthesia at our department between 01.01.2015 and 15.10.2015. The intensity of pain was assessed by the patients using a 10-point visual-analogue-scale. Routine blood samples before and after IDTT were compared, length of hospitalization and rate of bleeding complications determined. The follow-up included appointments two weeks and two months after surgery.
Results: Patients were hospitalized for 3.14 days on average. The median value of the C-reactive protein (CRP) decreased from 8 mg/dl on admission to 1.8 mg/dl within 3 days. The white blood cell count was normal at the patients discharge. The median pain intensity within the first three days after surgery was 1.84, 1.43 and 0.79, respectively. Re-draining of the abscess cavity was not necessary in any patient. There was one single patient who experienced a contralateral PTA two weeks after IDTT and finally underwent successful IDTT on this side, too. Postoperative bleeding did not occur. A malignant tumour was not identified in our patient population.
Conclusions: IDTT is a novel surgical technique associated with a rapid return to normal diet and activity. These findings are mirrored by a normalization of routine blood values (white blood cell count, CRP). IDTT eliminates the risk of painful re-draining and is free of bleeding complications. In contrast to ID and NA, histological examination of tonsillar tissue is feasible to disclose a previously undetected malign disease.
