-
Ugeskrift For Laeger Jun 2023
Topics: Humans; Peritonsillar Abscess; Emergency Service, Hospital; Ultrasonography
PubMed: 37325984
DOI: No ID Found -
Indian Journal of Otolaryngology and... Jun 2023Peritonsillar abscess (PTA) is the most common deep neck infection of the head and neck, but pharyngeal edema extending behind or below the tonsil and spreading to the...
UNLABELLED
Peritonsillar abscess (PTA) is the most common deep neck infection of the head and neck, but pharyngeal edema extending behind or below the tonsil and spreading to the larynx is atypical. Accurate diagnosis and prompt treatment are required because airway obstruction, descending mediastinitis, or thrombophlebitis may result. We evaluated surgical outcomes of inferiorly extended PTA (IEPTA) using an endoscope and a radiofrequency device for intraoral drainage. We retrospectively reviewed the medical records of 56 patients with IEPTA who underwent incisional drainage between 2013 and 2021. Two experienced surgeons performed intraoral drainage using an endoscope and a radiofrequency device (endoscopic group [EG]) or without such devices (WEG). Thirty (male: 26, female: four; mean age: 51.3 years), and 26 (male: 21, female: five; mean age: 55.9 years) patients in the EG and WEG, respectively, were evaluated. The mean hospitalization durations were 6.7 and 14.5 days for the EG and WEG, respectively (p<0.01). There were significant between-group differences regarding the number of tracheostomies conducted to secure an airway or surgical field (EG: four (13.3%); WEG: 16 (61.5%); p<0.01. The hospitalization duration for patients undergoing tracheostomy was significantly shorter in the EG than in the WEG (9.3 vs. 18.5 days, respectively; p=0.01). No significant difference in the mean hospital stay was observed for patients who did not undergo tracheostomy ([EG: 6.3, WEG: 8.2] days; p=0.081). IEPTA drainage using an endoscope and a radiofrequency instrument can reduce duration of hospitalization and tracheostomy procedures compared with the conventional method.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12070-022-03362-0.
PubMed: 37275022
DOI: 10.1007/s12070-022-03362-0 -
Indian Journal of Otolaryngology and... Jun 2023Anti-tumor necrosis factor agents are widely used in treating ankylosing spondylitis, but they increase the risk of infection by suppressing the immune response....
Anti-tumor necrosis factor agents are widely used in treating ankylosing spondylitis, but they increase the risk of infection by suppressing the immune response. Therefore, physicians should be careful about recurrent infections in patients under anti-tumor necrosis factor agents.
PubMed: 37274971
DOI: 10.1007/s12070-022-03203-0 -
Asian Journal of Surgery Oct 2023
Topics: Humans; Peritonsillar Abscess; Neck
PubMed: 37268469
DOI: 10.1016/j.asjsur.2023.05.086 -
Laryngo- Rhino- Otologie Jun 2023
Topics: Adult; Humans; Peritonsillar Abscess; Risk Factors
PubMed: 37267961
DOI: 10.1055/a-1988-5679 -
Laryngo- Rhino- Otologie Jun 2023
Topics: Adult; Humans; Peritonsillar Abscess; Risk Factors
PubMed: 37267960
DOI: 10.1055/a-1988-5655 -
Cureus Apr 2023Lemierre's syndrome (LS) is a rare medical condition that involves an acute oropharyngeal infection leading to septic thrombophlebitis of the internal jugular vein...
Lemierre's syndrome (LS) is a rare medical condition that involves an acute oropharyngeal infection leading to septic thrombophlebitis of the internal jugular vein with embolic spread to organs like the kidneys, lungs, and large joints. Only very little literature has reported central nervous system involvement with LS. This is a case of 34-year-old woman with right-sided neck pain, swallowing difficulties, and a sore throat of 3 days duration at the time of presentation. CT of the neck with contrast showed a ruptured right peritonsillar abscess and thrombus in the right internal jugular vein suspicious of thrombophlebitis. The patient was managed for LS with IV antibiotics and anticoagulation. However, her clinical course was complicated by cranial nerve XII palsy, which is an extremely rare manifestation of LS.
PubMed: 37252571
DOI: 10.7759/cureus.38181 -
The Journal of Laryngology and Otology Sep 2023Peritonsillar abscess is a localised infection in the peritonsillar space. Pus from the abscess can contain anaerobes. Many clinicians prescribe metronidazole in... (Review)
Review
BACKGROUND
Peritonsillar abscess is a localised infection in the peritonsillar space. Pus from the abscess can contain anaerobes. Many clinicians prescribe metronidazole in addition to penicillin, but evidence to support this is limited. This review assessed the evidence of benefit of metronidazole for the treatment of peritonsillar abscess.
METHODS
A systematic review was conducted of the literature and databases including Ovid Medline, Ovid Embase, PubMed and Cochrane library. Search terms included all variations of peritonsillar abscess, penicillin and metronidazole.
RESULTS
Three randomised, control trials were included. All studies assessed the clinical outcomes after treatment for peritonsillar abscess, including recurrence rate, length of hospital stay and symptom improvement. There was no evidence to suggest additional benefit with metronidazole, with studies suggesting increased side effects.
CONCLUSION
Evidence does not support the addition of metronidazole in first-line management of peritonsillar abscess. Further trials to establish optimum dose and duration schedules of oral phenoxymethylpenicillin would benefit clinical practice.
Topics: Humans; Peritonsillar Abscess; Metronidazole; Penicillins; Penicillin V; Drainage; Anti-Bacterial Agents
PubMed: 37194922
DOI: 10.1017/S0022215123000804 -
Vestnik Otorinolaringologii 2023To compare the pain during the postoperative period after the extracapsular tonsillectomy, performed with the 1.94 µm laser and cold steel tonsillectomy. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare the pain during the postoperative period after the extracapsular tonsillectomy, performed with the 1.94 µm laser and cold steel tonsillectomy.
MATERIAL AND METHODS
Sixty patients with chronic decompensated tonsillitis were enrolled in the study. Patients were randomized into two groups: the first one was subjected to cold steel tonsillectomy; in the second group tonsillectomy was done using a laser with 1.94 µm wavelength at pulsed mode. Patients' anamnesis was evaluated (the presence of signs of a toxic-allergic form of the disease, peritonsillar abscesses, the duration of the disease and the frequency of exacerbations of tonsillitis per year). In the postoperative period patients filled out questionnaires: the severity of pain was assessed for 10 days in points from 0 to 10, and painkiller use frequency per day.
RESULTS
Statistical analysis revealed that the pain after tonsillectomy depends on the presence of peritonsillar abscesses in the anamnesis. In patients with abscesses, the pain and the need for anesthesia are significantly lower with the laser technique compared with cold steel. The tonsillectomy technique does not affect the risk of postoperative bleeding (in both groups - 1/30).
CONCLUSION
The postoperative period after extracapsular laser tonsillectomy is characterized by significantly less pain than traditional tonsillectomy with cold instruments in patients with a history of peritonsillar abscess. Laser tonsillectomy does not have an increased risk of bleeding compared to traditional tonsillectomy.
Topics: Humans; Chronic Disease; Lasers; Pain, Postoperative; Peritonsillar Abscess; Tonsillectomy; Tonsillitis; Laser Therapy
PubMed: 37184553
DOI: 10.17116/otorino20228802138 -
Cureus Apr 2023Infectious mononucleosis (IM) is caused by Epstein-Barr virus (EBV), and the condition is characterized by sore throat, fever, lymphadenopathy, and atypical...
Infectious mononucleosis (IM) is caused by Epstein-Barr virus (EBV), and the condition is characterized by sore throat, fever, lymphadenopathy, and atypical lymphocytosis. These infections are common in early childhood, with a second peak occurring in late adolescence. EBV is spread by contact with oral secretions. Most cases of IM are self-limited. However, there are associated complications, some of which can be serious and fatal. We report the case of a 20-year-old man with splenic infarction and exuberant peritonsillar abscess secondary to an EBV infection. This case highlights the importance of accurate diagnoses and frequent monitoring in IM patients, given the risk of airway obstruction.
PubMed: 37182037
DOI: 10.7759/cureus.37414