| An evidence based review of peritonsillar abscess. | |
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MedLine Citation:
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PMID: 22321140 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective of review: We present the current literature surrounding peritonsillar abscess management highlighting areas of controversy. Type of review and search strategy: Literature review using Medline and Embase databases (search terms 'peritonsillar abscess', 'peritonsillar infection' and 'quinsy') limited to articles published 1991-2011 (English language). Results: 1) Investigations: Intraoral ultrasound has a sensitivity and specificity of between 89%-95% and 79%-100% respectively for correctly diagnosing peritonsillar abscess and is underutilised currently. 2) Medical management: Steroids can effectively aid recovery, reducing hospitalisation time and improving symptom relief, however further study is needed, especially related to risk and cost benefit. Penicillin and metronidazole are an effective combination in 98-99% of cases of peritonsillar abscess. 3) Surgical management: Overall there is no convincing evidence in favor of either aspiration or incision & drainage. Quinsy tonsillectomy is subject to great geographic variation, however is a safe procedure and reduces overall recovery time when compared with interval tonsillectomy. 4) Admission: Peritonsillar abscess can be effectively managed as an outpatient in many cases. 5) Further management: Overall the recurrence rate of peritonsillar abscess is poorly defined but estimated as 9-22% based on current evidence. Interval tonsillectomy may be indicated in selected groups of patients at high risk of recurrence. Conclusions: Peritonsillar abscess is a common condition with increasing incidence. We demonstrate the potential for evidence-based modifications in clinical management. However, lack of national consensus may mean that this evidence base is not being adequately exploited in current practice. A national audit of peritonsillar abscess management, in particular looking at recurrence rates and patient experience with different management strategies, appears indicated. © 2012 Blackwell Publishing Ltd. |
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Authors:
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J Powell; J A Wilson |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-9 |
Journal Detail:
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Title: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery Volume: - ISSN: 1749-4486 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101247023 Medline TA: Clin Otolaryngol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Blackwell Publishing Ltd. |
Affiliation:
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Department of Otolaryngology Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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