Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

Tsikopoulos, Alexios; Fountarlis, Athanasios Luca; Tsikopoulos, Konstantinos; Dilmperis, Fotios; Garefis, Konstantinos; Tsikopoulos, Ioannis; Karkos, Petros D.; Triaridis, Stefanos

doi:10.1007/s00405-022-07294-x

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…Many investigators have even found that a quinsy tonsillectomy is easier to perform than an elective one because the abscess partially dissects the tonsil from the surrounding tissue and makes it easier to find the peritonsillar plane, unlike the fibrosis found during interval tonsillectomy. 3,9 In a systematic review and meta-analysis, different authors have stated that they opt for a quinsy tonsillectomy as the first line of treatment. They have not found statistically significant differences in terms of bleeding rates (4.7% for quinsy tonsillectomy versus 5.4% for interval tonsillectomy) or surgery duration.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a quinsy tonsillectomy entails a shorter length of hospital stay because the patient undergoes the incision and tonsillectomy in the same hospitalization, in contrast to the interval tonsillectomy that requires 2 hospital admissions. 3,9 Lehnerdt conducted a retrospective study that compared both procedures with an age-and sex-matched group in both pediatric and adult populations. In the group of tonsillectomy with unilateral abscess, 8% had post-operative bleeding versus 11.6% in the elective tonsillectomy group.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral peritonsillar abscess. A case report and review of controversies surrounding diagnosis and management

2024

Arch Argent Pediat

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The bilateral presentation of peritonsillar abscess is uncommon. Its management is controversial and it has been argued whether a quinsy tonsillectomy or an interval tonsillectomy should be performed.Here we describe the case of a 14-year-old boy with sore throat, trismus, and fever. He had bilateral tonsillar hypertrophy, convex arches, and soft palate edema. Computed tomography: bilateral tonsillar hypertrophy, with post-contrast enhancement, both with collection, edema with moderate pharyngeal stenosis. The patient was hospitalized for intravenous therapy and tonsillectomy with bilateral drainage resulting in a complete resolution of his condition and discharge at 48 hours.In the presence of a peritonsillar abscess, an unsuspected contralateral abscess should be considered. It should be diagnosed and managed adequately to prevent complications. Quinsy tonsillectomy could be safe and should be considered in patients who will undergo anesthesia for abscess drainage. The final decision should be made for each patient on an individual basis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral peritonsillar abscess. A case report and review of controversies surrounding diagnosis and management

2024

Arch Argent Pediat

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“…Incluso muchos investigadores han encontrado que estas amigdalectomías son de mayor facilidad que las electivas, ya que el absceso diseca parcialmente la amígdala del tejido circundante y facilita encontrar el plano periamigdalino, distinta a la fibrosis hallada en la amigdalectomía en diferido. 3,9 D i s t i n t o s a u t o r e s , e n u n a r e v i s i ó n sistemática y metanálisis, declaran que eligen la amigdalectomía inmediata como primera línea de tratamiento. No observan diferencias estadísticamente significativas en cuanto a la tasa de sangrado (el 4,7 % inmediata versus el 5,4 % diferida) ni en cuanto a tiempo operatorio.…”

Section: Discussionunclassified

“…Además, presentan una estancia hospitalaria más corta, ya que el paciente es sometido a incisión y amigdalectomía en la misma internación, en contraste al procedimiento en diferido que requiere dos admisiones. 3,9 Figura…”

Section: Discussionunclassified

Absceso periamigdalino bilateral. Reporte de un caso y revisión de las controversias en el diagnóstico y tratamiento

2024

Arch Argent Pediat

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La presentación bilateral del absceso periamigdalino es poco frecuente. Su abordaje es controversial y se discute si realizar amigdalectomía en caliente versus diferida.Se presenta el caso de un paciente de sexo masculino, de 14 años, con odinofagia, trismo y fiebre. Presentaba hipertrofia amigdalina bilateral, pilares abombados y edema de paladar blando. Tomografía computada: hipertrofia amigdalina bilateral, con realce poscontraste, ambas con colección, edema con moderada estenosis faríngea. Se decidió internación para tratamiento endovenoso y amigdalectomía con drenaje bilateral. Resolución completa del cuadro con alta a las 48 horas.Ante la presencia de un absceso periamigdalino, debe considerarse la posibilidad de un absceso contralateral oculto. Debe ser diagnosticado y tratado adecuadamente para prevenir complicaciones. La amigdalectomía en caliente podría ser un tratamiento seguro y debería ser considerado en pacientes que serán sometidos a anestesia para drenaje. La decisión final debe ser determinada para cada caso en particular.

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Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy‐A Meta‐Analysis

Mughal,

Gupta,

Yeo

et al. 2024

The Laryngoscope

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ObjectiveAbscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post‐tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.Data SourcesA search was performed on August 27, 2023 in Medline, Embase, PubMed, Cochrane CENTRAL, and Web of Science databases.Review MethodsThe systematic review was conducted in adherence to the PRISMA guidelines. Pooled PTB rate was determined using a meta‐analysis of proportions. The JBI tool was used to assess the quality of the included studies.ResultsOf the 525 search records, 18 studies met the eligibility criteria for final analysis. These comprised of retrospective single‐center analyses. The pooled prevalence of PTB was 6.65% (95% C.I. 4.01–9.81), and the return‐to‐theatre rate was 2.35% (95% C.I. 1.48–3.37). There was no difference in PTB rate between unilateral and bilateral tonsillectomy. However, the bipolar technique was associated with a higher PTB rate compared to cold steel dissection. The overall quality of the body of evidence was moderate.ConclusionOur study highlights the complications associated with abscess tonsillectomy. These findings contribute valuable insights into this potential treatment option for quinsy.Level of EvidenceN/A Laryngoscope, 2024

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Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

Cited by 10 publications

References 27 publications

Bilateral peritonsillar abscess. A case report and review of controversies surrounding diagnosis and management

Bilateral peritonsillar abscess. A case report and review of controversies surrounding diagnosis and management

Absceso periamigdalino bilateral. Reporte de un caso y revisión de las controversias en el diagnóstico y tratamiento

Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy‐A Meta‐Analysis

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