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OBJECTIVE The presence of untreated pus within the peritonsillar space can herald the occurrence of various clinical scenarios that could be difficult to describe. In this article we discuss the “TWISTS AND TURNS OF PERITONSILLAR ABSCESS” we have met in the Northwestern region of Nigeria that have not yet been reported in the literature and to compare the means of symptom duration at presentation among study groups. MATERIAL AND METHODS It is a retrospective study. A total number of 25 patients formed the study population (N) and were classified into three: Group 1 included patients who presented early with peritonsillar Abscess and had expected clinical course following treatment. Group 2 included patients who presented late and thus had one twist or the other from the usual presentation. Group 3 included patients who died. RESULTS The mean age = 24 ± 11 years. Sore throat, dysphagia and fever were the most common symptoms. Asymmetrically enlarged tonsil was the most common oropharyngeal finding with occasionally occurring twists and turns such as gangrenous tonsil, auto-tonsillectomy, and severely bleeding tonsil. CONCLUSION Peritonsillar abscess (PTA) constitutes a relentless infection that needs urgent, adequate treatment based on acceptable methods, delay in presentation can herald the occurrence of pathologies that could be difficult to interpret. KEY WORDS: Peritonsillar Abscess, Auto-tonsillectomy, Gangrenous tonsil.

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Background: Neck trauma is a potentially life threatening clinical condition often presenting as a challenging surgical emergency to otolaryngologist due to high concentration of vital structures in the neck that are at risk. We aimed to study the clinical profile and management challenges of neck trauma in our environment.Methods: This is a retrospective study in which case records of patients diagnosed with neck trauma over 6 years (January 2013 to December 2018) were reviewed. Data extracted included the demography, etiology, presenting symptoms, nature of trauma, surgical intervention and their complications.Results: A total of 28 cases of neck trauma 15 (53.6%) males and 13 (46.4%) females with an M: F ratio of 1.2:1 was analyzed. Age range 8 years to 60 years with a mean age of 30.2 years. The highest incidence was 39.3% in patients within the age group 21-30years. Hoarseness and difficulty in breathing were the commonest presenting symptoms. The commonest etiology of neck trauma in this study is accidental 17 (60.7%) followed by homicidal 6 (21.4%) with zone II site of the neck being the commonest site of injury. Most cases presented to the hospital 2-8 hours of trauma except 5 patients that took more than 24 hours. Nineteen of the patient had emergency tracheostomy and Neck exploration. Most common complication was supraglottic stenosis 12 (42.8%). No mortality recorded in this study.Conclusions: Neck trauma is a potentially life threatening surgical emergency requiring timely multi-disciplinary management thereby reducing complications and postoperative morbidity.