Peritonsillar Abscess: Is Incision Drainage Superior to Abscess Tonsillectomy?

Objective: To compare the post operative morbidity associated with incision drainageVersus abscess tonsillectomy in the management of peritonsillar abscess by measuring the frequency of postoperative haemorrhage, severity of postoperative pain, duration of hospital stay and recurrence. Study Design: Quasi experimental study. Place and duration: ENT Department, Govt Lady Reading Hospital, Peshawar, over a period of three years. Materials and Methods: The study included patients of either sex, aged between 15 to 40 years, presenting with peritonsilar abscess. Patients were divided in to two groups. Group I Consisted of Patient in whom incision Drainge of abscess was don where as in Group II, Abscess Tonsillectomy was Carried out. Patients were assigned to either Group by a Random Sampling Technique. The two groups were matched for age, gender, and duration of illness. All patients were Preoperatively managed on indoor basis with intravenous fluid resuscitation, intravenous antibiotics and analgesics. The various outcome measures included postoperative haemorrhage, postoperative pain, and duration of hospitalization and recurrence of abscess. All the patients were kept in the ward for observation and indoor management for a minimum of 24 hours postoperatively. Following discharge, follow up was done for up to three months to document any recurrence. Results In total of 60 patients were studied, of whom, 36(60%) were males, and 24(40%) females, Age ranging between 15 to 40 years. Secondary haemorrhage was observed among five patients after abscess tonsillectomy as compared to one patient with incision drainage. Two patients also developed reactionary haemorrhage after abscess tonsillectomy. Severe postoperative pain was also significantly frequent among patients where abscess tonsillectomy was employed. Duration of hospitalization was significantly more among patients with abscess tonsillectomy. Recurrence was observed among two patients with incision drainage while no recurrence in the patients with abscess tonsillectomy group. Conclusion The post operative morbidity associated with abscess tonsillectomy is comparatively higher than that associated with incision drainage. Therefore, incision drainage is superior and hence recommended for managing peritonsillar abscess.