University Of Health Sciences, Evliya Celebi Training and Research Hospital, Department of Otolaryngology, Head and Neck Surgery, Kütahya 43000, Turkey.
Mersin City Hospital, Department Radiology, Mersin, Turkey.
Auris Nasus Larynx. 2020 Dec;47(6):1027-1032. doi: 10.1016/j.anl.2020.06.001. Epub 2020 Jun 21.
Peritonsillar abscess (PTA) is one of the most commonly seen ear nose and throat (ENT) emergencies. The most catastrophic complication that may occur due to surgical treatment of PTA is injury of internal carotid artery. The aim of this study is to determine distance and angle between PTA with ICA; and to prevent possible complications.
A total of 34 adult patients with PTA were enrolled in this study. Neck computed tomographies of the patients with PTA were evaluated by a radiologist. The distance between PTA and ICA (DIP), and contralateral tonsil side and ICA (DIT) were measured and compared with each other. Also angle between PTA and ICA (AIP) was examined.
This study contained 20 (58.8%) males and 14 (41.2%) females with a mean age of 32.20 ± 12.75 years (range 18-60 years). Mean DIP and DIT scores were 13.39 ± 3.7 mm (min: 5.32, max: 19.07) and 9.61 ± 3.17 mm (min: 4.95, max: 16.35) respectively, and the difference was statistically significant (p<0.05). Mean distance between anterior border of PTA and ICA was 36.18 ± 6.42 mm (min: 17.12 max: 47.43). The AIP was 33.40 ± 2.29° (min: 30.10° and max: 40.71°). According to risk classification system, the 28 (82.4%) patients constituted low risk, and 6 (%17.6) patients constituted moderate risk.
According to the distance between the PTA and ICA, the risk of ICA injury was found to be mild and moderate in PTA patients. It is crucial for the surgeon to pay attention to the depth and angle of the incision during drainage of the abscess.
扁桃体周脓肿（PTA）是耳鼻喉科（ENT）最常见的急症之一。由于 PTA 的手术治疗，可能发生的最灾难性的并发症是颈内动脉损伤。本研究的目的是确定 PTA 与颈内动脉（ICA）之间的距离和角度；并预防可能发生的并发症。
共纳入 34 例 PTA 成年患者。由放射科医生对 PTA 患者的颈部计算机断层扫描进行评估。测量并比较 PTA 与 ICA（DIP）之间、对侧扁桃体侧与 ICA（DIT）之间的距离。还检查了 PTA 与 ICA 之间的角度（AIP）。
本研究包含 20 名（58.8%）男性和 14 名（41.2%）女性，平均年龄为 32.20±12.75 岁（范围 18-60 岁）。平均 DIP 和 DIT 评分分别为 13.39±3.7mm（最小值：5.32，最大值：19.07）和 9.61±3.17mm（最小值：4.95，最大值：16.35），差异有统计学意义（p<0.05）。PTA 前边界与 ICA 之间的平均距离为 36.18±6.42mm（最小值：17.12，最大值：47.43）。AIP 为 33.40±2.29°（最小值：30.10°，最大值：40.71°）。根据风险分类系统，28 例（82.4%）患者为低危，6 例（17.6%）患者为中危。
根据 PTA 与 ICA 之间的距离，发现 PTA 患者的 ICA 损伤风险为轻度和中度。对于外科医生来说，在脓肿引流过程中，注意切口的深度和角度至关重要。
