What is the role of tonsillectomy in the treatment of peritonsillar abscesses (PTAs)?

Updated: Sep 03, 2020
  • Author: Jorge Flores, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

No clear evidence indicates that routine elective tonsillectomy is indicated to prevent future peritonsillar abscesses. However, if the patient has had multiple recurrent episodes of peritonsillar abscesses or has other clear indications (ie, sleep-disordered breathing), elective tonsillectomy should be considered. [9]

Additionally, if general anesthesia is required because of the patient's age or lack of cooperation, tonsillectomy should be considered, as the complication rate is low. Although the data do not support this, consideration for the most definitive procedure should be made. [9, 2]

An Italian study indicated that following incision and drainage for peritonsillar abscess, the risk of abscess recurrence is not significantly different between patients who are subsequently managed conservatively and those who undergo tonsillectomy, as long as the patients have not had previous episodes of peritonsillar abscess. The study involved 4199 hospital inpatients who, after incision and drainage, received either conservative treatment (2667 patients) or tonsillectomy (1532 patients). Although the tonsillectomy rate among these patients fell by 45% between 1997 and 2006, the investigators found that the incidence of hospitalization for peritonsillar abscess remained stable during this period. [21]


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