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Peritonsillar abscess ( quinsy)

– definition:

Peritonsillar abscess is collection of pus between fibrous capsule of the tonsil and superior constrictor muscle.

– aetiology:

Peritonsillar abscess usually develops as a complication of acute tonsillitis and caused by mixed aerobic and anaerobic organisms.

Peritonsillar abscess usually affects young adults.

– pathology:

Start by infection in the depth of one of the crypts ( usually crypta magna ).

– symptoms:

General: fever, headache ,malaise.

Local: sore throat , severe dysphagia and odynophagia ,foetor Oris ,unilateral neck pain and referred otalgia.

-Signs:

General: fever, tachycardia,toxic facies.

Local: trismus, tonticollis

  1. Asymmetrical oedema and congestion of soft palate.
  2. Swelling above and lateral to the tonsil.
  3. Tonsil is displaced downwards and medially.
  4. Uvula is oedematous and pushed to the other side.
  5. Large,firm,tender jugulodigastric lN.

– treatment:

During stage of peritonsillar cellulitis :-

  1. parentral antibiotics.
  2. Antipyretics, analgesics.
  3. Bed rest.
  4. Adequate fluids , mouth wash.

During stage of peritonsillar abscess:-

  1. Incision and drainage.
  2. Parentral antibiotics.

– tonsillectomy should be done 4_6 weeks after peritonsillar abscess incision.



Category | ENT, Oral Surgery
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