Peritonsillar abscess

Indications for tonsillectomy stratified by the level of evidence

“…Only 7.9 to 56% of the patients with PTA repoted recurrent episodes of tonsillitis their history [257], [260], [266], [270], [290], [291], [301], [302], [303], [304], [305], [306], [307], [308], [309], [310], [311], [312], [313], [314], [315], [316], [317], [318], [319]. This aspect is confirmed by current studies where a correlation between tonsillitis in the patients’ history and PTA was found in only about half of the PTA patients [269], [320].…”

“…Among those 42 publications, there were only 5 level I trials [263], [304], [345], [363], [364], the remainder were classified as level IV including 13 case series with only one treatment modality [301], [302], [303], [305], [314], [343], [358], [374], [375], [376], [377], [378], [379], 12 case series comparing different therapies [261], [264], [307], [308], [366], [380], [381], [382], [383], [384], [385], [386], and one economic analysis [301]. Concerning recurrence rates and indication, the authors found 2 level II studies [309], [313] and 13 level IV trials [301], [303], [310], [311], [312], [314], [343], [350], [361], [372], [387], [388], [389]. From the 5 randomized trials, 3 compared the outcome after NA vs. ID in cohorts of 5 [304], 60 [363], and 62 patients [345] and could not reveal a significant difference.…”

“…Rarely, a second NA becomes necessary [303], [305], [306], [307], ,[358] [375], [396]. In different studies, NA and ID proved to have a comparable outcome [304], [345]; in the study by Wolf et al [308] ID was initially more successful than NA and in the study by Savolainen et al [306] it was better in the following course.Recurrence rate: The recurrence rate was given with 0% to 23% in the literature analyzed by Herzon [261], [302], [303], [304], [305], [307], [308], [309], [310], [311], [313], [314], [350], [358], [378], [383], [386], [397]. An age <30 years [398], previous PTA [306], and a history of recurrent tonsillitis episodes [309] proved to be risk factors for the development of PTA recurrences, mostly within 2 to 12 months [306], [309].…”

“…An age <30 years [398], previous PTA [306], and a history of recurrent tonsillitis episodes [309] proved to be risk factors for the development of PTA recurrences, mostly within 2 to 12 months [306], [309]. Other reports could not identify a correlation between tonsillitis episodes in the patients’ history and PTA [310], [312], [313], [314]. …”

“…Recurrence rate: The recurrence rate was given with 0% to 23% in the literature analyzed by Herzon [261], [302], [303], [304], [305], [307], [308], [309], [310], [311], [313], [314], [350], [358], [378], [383], [386], [397]. An age <30 years [398], previous PTA [306], and a history of recurrent tonsillitis episodes [309] proved to be risk factors for the development of PTA recurrences, mostly within 2 to 12 months [306], [309].…”