Galluzzi Francesca, Garavello Werner
Department of Otorhinolaryngology, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy.
Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy.
J Clin Med. 2024 Dec 3;13(23):7361. doi: 10.3390/jcm13237361.
This review aims to analyze the treatment options for peritonsillar abscess (PTA) in children. We searched PubMed and EMBASE for studies regarding the treatment of PTA in children. Relevant studies were reviewed based on systematic review (PRISMA) guidelines. Qualitative and quantitative analyses of the extracted data were performed. A total of 12 articles with 2211 cases of PTA were found to be eligible. All the identified studies were retrospective cohorts. The mean age varied from 8.5 to 15.4 years without gender difference. Treatment options included broad-spectrum antibiotic therapy with incision and drainage of the abscess, needle aspiration and immediate tonsillectomy in 69%, 7.6% and 7% of cases, respectively. Antibiotics alone were administered to 16.4% of the subjects. The rate of recurrence of PTA after primary treatment ranged from 2% to 15.8% of cases. The time of recurrence is considered within one or two months. Complications in children with PTA were torticollis, prolonged fever, sepsis, dyspnea and parapharyngeal involvement. The mainstay of treatment of PTA in children is antibiotic therapy with incision and drainage of the abscess. Alternatives include antibiotic treatment alone or in association with needle aspiration. Immediate tonsillectomy is reserved only for a few high-risk patients.
本综述旨在分析儿童扁桃体周脓肿（PTA）的治疗选择。我们在PubMed和EMBASE上检索了关于儿童PTA治疗的研究。根据系统评价（PRISMA）指南对相关研究进行了综述。对提取的数据进行了定性和定量分析。共发现12篇文章，涉及2211例PTA病例，均符合要求。所有纳入研究均为回顾性队列研究。平均年龄在8.5至15.4岁之间，无性别差异。治疗选择包括广谱抗生素治疗并切开引流脓肿、针吸以及立即扁桃体切除术，分别占病例的69%、7.6%和7%。16.4%的受试者仅接受抗生素治疗。初次治疗后PTA的复发率在2%至15.8%之间。复发时间被认为在一到两个月内。PTA患儿的并发症有斜颈、持续发热、败血症、呼吸困难和咽旁受累。儿童PTA治疗的主要方法是抗生素治疗并切开引流脓肿。其他选择包括单独使用抗生素治疗或联合针吸。立即扁桃体切除术仅适用于少数高危患者。
