Quinsy tonsillectomy in the management of peritonsillar abcess in children

The treatment of peritonsillar abcess in children is controversial: it consists either of immediate drainage followed by interval tonsillectomy, either of immediate tonsillectomy (abcess tonsillectomy or quinsy tonsillectomy). The authors report 3 cases of quinsy tonsillectomy performed in children with peritonsillar abcesses.

Renal Clear Cell Carcinoma and Tonsil Metastasis

Renal cell carcinoma is the most common renal tumor in adults. Clear cell carcinoma represents 85% of all histological subtypes. In February 2012 a 72-year-old woman came to our department due to the appearance of massive hemoptysis and pharyngodinia. Previously, this patient was diagnosed with a renal cell carcinoma treated with left nephrectomy. We observed an exophytic, grayish, and ulcerated mass in the left tonsillar lodge and decided to subject the patient to an immediate tonsillectomy. Postoperative histology showed nests of cells with highly hyperchromatic nuclei and clear cytoplasm. These features enabled us to make the diagnosis of renal clear cell carcinoma metastasis. Only few authors described metastasis of renal cell carcinoma in this specific site.

Immediate tonsillectomy: indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess

Objectives:This study was designed to evaluate the efficacy and morbidity of immediate tonsillectomy used to treat peritonsillar abscess (quinsy) and parapharyngeal abscess.Subjects and method:This four-year, retrospective study was based on 31 patients hospitalised in a university hospital ENT and head and neck surgery department for peritonsillar and/or parapharyngeal abscess. All patients underwent immediate, bilateral tonsillectomy. The length of hospital stay, duration of antibiotic therapy, microbiological findings, complications, and the time to complete recovery and oropharyngeal healing were recorded.Results:The patients' mean post-tonsillectomy hospital stay was 2.84 days (median: 3 days). No post-operative haemorrhage was observed. All patients were considered to be cured at the day 10 follow-up visit, and complete oropharyngeal healing was observed at the day 21 visit. The duration of antibiotic therapy ranged from 10 to 15 days (mean: 11.5 days; median: 10 days).Discussion and conclusion:Immediate tonsillectomy appears to be a safe and effective surgical technique for the management of peritonsillar and parapharyngeal abscess; in particular, it markedly reduces patients' hospital stay (when performed early in the course of the disease) and duration of antibiotic therapy. Immediate tonsillectomy has become the first-line treatment for parapharyngeal abscess and several types of peritonsillar abscess in our department.

Unilateral immediate tonsillectomy as the treatment of peritonsillar abscess: Results, with special attention to pharyngitis

The results of unilateral immediate tonsillectomy, as the routine treatment of peritonsillar abscess, were studies in 47 patients with no previous history of serious tonsillitis. The follow-up was carried out between three and four years after operation.The incidence of tonsillitis in the contralateral tonsil remained unchanged and peritonsillar abscess did not occur in that tonsil. Symptoms of pharyngitis, periodic or chronic, were present in three patients only. This was found to be significantly lower than that found in the literature in a similar group of patients in whom bilateral immediate tonsillectomy had been performed.The results are discussed and the authors recommend unilateral immediate tonsillectomy in cases of peritonsillar abscess in all patients with no previous history of serious tonsillitis, as this apparently prevents the troublesome side-effects of chronic pharyngitis.

Peritonsillar Abscess in the Pediatric Population

This paper reports on 115 pediatric patients who were treated for peritonsillar abscess at The Columbus Children's Hospital. Its purpose is to document the threefold increase of peritonsillar abscess between 1969 and 1978, relating this to the simultaneous decrease in the number of tonsillectomies by about one third. The paper further shows that 55 of 115 patients underwent successful treatment by immediate tonsillectomy with lower morbidity and shorter hospital stay when compared with 60 patients treated medically. The timing of the operation will also be discussed. We believe that immediate tonsillectomy is the treatment of choice.