JOURNAL READING

MANAGEMENT OF PERITONSILLAR ABSCESS:

COMPARATIVE PROSPECTIVE STUDY OF NEEDLE
ASPIRATION AND INCISION & DRAINAGE IN CENTRAL
INDIAN POPULATION

Pembimbing :

dr. Afif Zjauhari, Sp. THT-KL

Oleh :

Fataaturrohmatil Usroh

Rizky Asvianto Aji

 JOURNAL IDENTITY

Vikram Kulkarni, Teklal Patel

Department of ENT, Chirayu
Medical College and Hospital,
Bhopal, India Department of ENT,
L.N. Medical College and Research
centre, Bhopal, India
 BACKGROUND

Peritonsillar
abses

Acute Peritonsillar
tonsillitis cellulities

The treatment is
controversial- medical or
surgical.
 METHODE
140 patients with peritonsillar
abses and the age group 20 to
40 years

Group 1 Group 2

Incision and Needle aspiration

Drainage (BIOPSI)
 RESULT

Group 1: Group 2:
- 78 patients, PTA
recurred : - 62 patients, PTA
• once in 4 patients recurred :
• twice in 2 • 7 patients showed
patients. recurrence

hospital stay 3.6 and 2.9 days respectively in both cases.

 CONCLUSSION

Incision and drainage > needle aspiration.

first step management: Needle aspiration, it is

simple, cheap, effective and less traumatic to
the patients.
 INTRODUCTION

Peritonsillar infections are the most

infections of deep tissues of the head
and neck region both in adults and
children
 Complications of peritonsillar :
• Thrombosis
• Mediastinitis
• Pericarditis
• Pneumonia
• Upper airway obstruction
The aim of this study was
to compare

Incision & Needle

Drainage aspiration
MATHERIAL AND METHODE

• During 2 year period (December

2010 to January 2013)
• patients of peritonsillar abscess
above 15 years
• A written informed consent
• Peritonsillar abscess was
diagnosed
Diagnose Peritonsillar Abses

• Swollen upper pole of tonsil

• Swollen and deviated uvular
• Trismus
• presence of pus
 METHODE
All patients were divided in two
groups according to surgical
procedures carried out

Group 1 Group 2

Incision and Needle aspiration

Drainage (BIOPSI)
Surgical Procedure:
- Using 10% Lignocaine,
- a small curvilinear incision
- A blunt artery forceps was put into the
incision and spread until adequate drainage
- Needle aspiration with a wide bore 18-
gauge needle on a 10-ml syringe at the site
of maximum swelling.
- The position of the needle is changed and
drainage considered adequate when no
more pus was aspirated.
Surgical Procedure:
- All the patients were given the same preoperative
and postoperative antibiotic therapy along with
intravenous fluid and analgesics as needed.
- The parameters studied were sex predisposition,
age of the patient, history of recurrent tonsillitis,
hospital stay, PTA recurrence, complications, etc
 RESULT

140 patients with symptoms of peritonsillar abscess

during 2 year period (December 2010 to January
2013)
 DISCUSSION
Peritonsillar abscesses generally develop from
tonsillitis to cellulitis and finally abscess formation.
 DISCUSSION

Mastuda et al7 (2002) reported that a quarter of patients

were 40 years or older. The study by Schraff et al only
conducted in the pediatric population.
 DISCUSSION

Khan MI et al3, Habib M et al8 recorded higher male

preponderance.
 DISCUSSION

Khan MI et al3 recorded longer mean

hospital stay in NA group. The possible reason
may be failure of initial attempt on needle
aspiration which was finally dealt with incision
and drainage.
 DISCUSSION

Appropriate precautions taken and proper

antibiotics are administered. Drainage of pus
to maximum extent is the most important
step.
 DISCUSSION

• Usual causative bacteria are changing from gram

positive cocci (mainly streptococcus hemolyticus
group A) to anaerobes and gram negative rods
 THE BILATERAL
PERITONSILLAR ABSESSES
 CONCLUSION

- Incision and drainage > needle aspiration.

- first step is Needle aspiration, it is simple, cheap,

effective and less traumatic to the patients.
•THANK YOU 