Peritonsillar abscess. I. Cases treated by incision and drainage: a follow-up investigation.

The purpose of the present follow-up investigation was to evaluate the indications for tonsillectomy à chaud in the presence of a peritonsillar abscess. Of 76 consecutive patients treated for peritonsillar abscess, 45 were treated by incision and drainage, and no tonsillectomy à froid was planned. None of these patients had had previous peritonsillar abscess or recurrent tonsillitis; therefore tonsillectomy was not indicated. A follow-up investigation including 44 of these 45 patients showed that among patients under 30 years of age, 63 per cent had another peritonsillar abscess or recurrent tonsillitis during he follow-up period. Within an average period of 3 years, 41 per cent in this group underwent tonsillectomy. Among patients older than 30 years only 12 per cent had recurrent tonsillar symptoms, and in no case was tonsillectomy performed. The indication for tonsillectomy à chaud is discussed, and the method is recommended as a routine in peritonsillar abscess in patients under 30 years old, whereas conservative treatment with incision and drainage is recommended in patients older than 30 years if the patient has had no previous peritonsillar abscess or recurrent tonsillitis.