Introduction
Peritonsillar abscess (PTA) is a frequent cause for ENT emergency consultation, caused by accumulation of pus in the peritonsillar space. Generally, therapy consists of empirical antibiotics and surgical therapy. The AWMF guideline "therapy of tonsillo-pharyngitis" names tonsillectomy (TE) as a treatment option if alternative therapy methods as incision have failed, complications occur, or in case of recurrence. With few exceptions bilateral TE for PTA is not advised anymore. We analysed the general risk for recurring PTA (rPTA) after uni- and bilateral TE and compared the risk of postoperative haemorrhage (POH) as a severe complication.
Material and methods
We analysed retrospective data of all abscess TEs performed in the ENT department of a university hospital between 06/2016 - 06/2024 using fisher's exact test and assessing the variables gender, age, side of operation, side of abscess, POH, side of POH, occurrence of rPTA.
Results
Of the 980 cases of abscess TE recorded, 66.9% were unilateral and 33.1% bilateral TEs. 18 cases of rPTA occurred after unilateral and 1 after bilateral abscess TE. Unilateral TE was associated with a significantly higher probability for rPTA (p-value <0.01).
POH was reported in 12.5% of unilateral and 19.4% of bilateral abscess TEs, showing a significantly higher risk for POH after bilateral TE (p-value <0.01). Also 36.5% of POH occurred on the contralateral side to PTA after bilateral TE, accounting for 15.9% of all POH.
Discussion
This retrospective analysis shows that the risk for rPTA is significantly higher after unilateral TE, but bilateral TE is associated with a significantly higher risk for POH, also on the contralateral side. These findings have to be adjusted with multicentric data.
Nein