Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Germany, Waldstrasse 1, 91054 Erlangen, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Germany, Waldstrasse 1, 91054 Erlangen, Germany.
Auris Nasus Larynx. 2021 Dec;48(6):1120-1125. doi: 10.1016/j.anl.2021.04.006. Epub 2021 Apr 25.
To identify the appropriate treatment in the tonsillar region's infections, a distinction between tonsillitis with or without abscess formation is essential. Ultrasound proved to be a valuable method in identifying abscess formation in the head and neck region. However, no report described the assessment of the tonsil region. This study aims to determine the feasibility of transcervical ultrasound for abscess visualization in the palatal tonsillar region.
Retrospective analysis of 354 patients presenting with clinical suspicion of tonsillar abscess to a tertiary referral center and university hospital. All patients received a transcervical ultrasound to establish a primary diagnosis. The existence of an abscess was confirmed by puncture and incision, or final tonsillectomy. If no abscess could be delineated, non-abscessing tonsillitis was supposed, and conservative primary therapy and closed follow-up examinations were performed.
After the first diagnostic ultrasound examination, in 257 cases (72.59%), the diagnosis of an abscess could be established, but in 97 cases (27.40%), due to missing abscess formation criteria, non-abscessing tonsillitis was documented. Overall, ultrasonography demonstrated an overall accuracy of 78.8% in this selected cohort. The sensitivity, specificity, PPV, and NPV after the first ultrasound examination were calculated with 75.1%, 88.6%, 94.6%, and 57.3%, respectively.
The presented data confirm that an abscess formation due to tonsillitis can be detected by transcervical ultrasound, enabling prompt, adequate management. As transcervical ultrasound can be conducted fast and is not associated with radiation, it can be regarded as a first-line diagnostic tool in this condition.
为了确定扁桃体区域感染的适当治疗方法，区分伴有或不伴有脓肿形成的扁桃体炎至关重要。超声已被证明是一种在头颈部区域识别脓肿形成的有价值的方法。然而，尚无报道描述对扁桃体区域的评估。本研究旨在确定经颈超声在评估腭扁桃体区域脓肿中的可行性。
回顾性分析了 354 例因临床疑似扁桃体脓肿而到三级转诊中心和大学医院就诊的患者。所有患者均接受经颈超声检查以建立初步诊断。脓肿的存在通过穿刺和切开或最终扁桃体切除术来确认。如果无法描绘出脓肿，则假定为非脓肿性扁桃体炎，并进行保守的初级治疗和封闭随访检查。
在首次诊断性超声检查后，在 257 例（72.59%）患者中，可以确定脓肿的诊断，但在 97 例（27.40%）患者中，由于缺乏脓肿形成标准，记录为非脓肿性扁桃体炎。总体而言，在该选定队列中，超声检查的总体准确性为 78.8%。首次超声检查后的灵敏度、特异性、PPV 和 NPV 分别计算为 75.1%、88.6%、94.6%和 57.3%。
所提供的数据证实，经颈超声可检测因扁桃体炎引起的脓肿形成，从而能够及时、充分地进行管理。由于经颈超声可以快速进行，并且不伴有辐射，因此可以将其视为该疾病的一线诊断工具。
