Management of Peritonsillar Abscess: comparative prospective study of Medical and Surgical Management (Needle Aspiration and Incision & Drainage in Kashmiri Population)

Peritonsillar abscess (PTA) is one of the most commonly encountered abscess in the Head and neck region. Peritonsillar abscess also called as Quinsy is commonest infection in head and neck region. It is collection of pus within the peritonsillar space as a result of acute tonsillitis and subsequent Peritonsillar cellulites. The aim of our study is to compare the efficacy of Medical and Surgical treatment surgical modalities available are- incision & drainage, needle aspiration. Methods: This prospective study was conducted at the Department of Otorhinolaryngology and Head & Neck Surgery, SMHS Hospital Srinagar (GMC Srinagar) for 15 months, from Nov 2015 to Jan. 2017. Adult patients (>20 years) of both sexes with unilateral peritonsillar abscess were included sequentially. Children, patients with acute follicular tonsillitis or peritonsillitis and those who refused incision and drainage under LA were excluded. All patients received the same antibiotic Amoxicillin/Clavunate and underwent needle aspiration and I&D procedure under LA. Results: 56 patients were included in the study, 25 males and 31females. Out of 56 patients, Peritonsillar abscess recurrence was 3 patients (16.6%) in Group1, 2 Patients (12.5%) in 2A and 2 patients (9.09%) in Group 2B. History of recurrent tonsillitis was noted in 12 Patients (66.6%) in Group1, 10 Patients (62.5%) in Group 2A and 13 Patients (59.09%) in Group 2B. Conclusion: Incision and drainage and needle aspiration are better treatment. But Needle aspiration can be utilized as first step of management of peritonsillar abscess as it is simple, cheap, effective and less traumatic to the patients. Medical Management can be considered in patients with less advanced symptoms or smaller abscess size. It has been observed that Medical Treatment has less complications but more recurrence compared to surgical treatment.