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Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 17 March 2022

Abstract

Objectives

Peritonsillar abscess is a common complication of acute tonsillitis. However, no consensus has been reached yet on the optimal treatment of this condition. Therefore, this study aimed to compare clinical outcomes of immediate and interval abscess tonsillectomy.

Methods

The databases of PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for completed studies published until the 1st of November 2021. Comparative studies assessing intraoperative and postoperative outcomes of immediate and interval abscess tonsillectomy were considered, with the primary outcome being postoperative hemorrhage. Operative time, intraoperative blood loss, postoperative pain, and duration of hospital stay were classed as secondary outcomes. A random-effects pairwise meta-analysis of both randomized and non-randomized trials was conducted. Subgroup analysis linked to the randomization of trials was executed. Quality assessment was performed, utilizing the Cochrane risk of bias tool and ROBINS-I tool for randomized and non-randomized trials, respectively.

Results

Data from 265 cases stemming from six trials were pooled together. For postoperative bleeding rates, no statistically significant difference between immediate and interval tonsillectomy was detected (OR = 1.26; 95% CI 0.27, 5.86; p = 0.77). By contrast, longer hospital stay was observed for patients subjected to interval tonsillectomy (SMD = − 0.78; CI − 1.39 to− 0.17; p = 0.01). For operative time and intraoperative blood loss, no statistically significant difference was noticed between immediate and interval tonsillectomy (SMD = 1.10; 95% CI − 0.13, 2.33; p = 0.08; and SMD = 0.04; 95% CI − 0.49, 0.57; p = 0.88; respectively).

Conclusions

This study shows that quinsy tonsillectomy appears to be a safe method, providing full abscess drainage and instant relief of the symptoms. Moreover, quinsy tonsillectomy was not associated with a statistically higher postoperative hemorrhage incidence rate than immediate tonsillectomy.

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. 1st Department of Otorhinolaryngology-Head and Neck Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 546 21, Thessaloniki, Greece

    Alexios Tsikopoulos, Petros Karkos & Stefanos Triaridis

  2. Department of Otorhinolaryngology, University General Hospital of Larissa, University of Thessaly, Larissa, Greece

    Athanasios Fountarlis & Charalampos Skoulakis

  3. Department of Orthopedics, 424 Army General Training Hospital, Thessaloniki, Greece

    Konstantinos Tsikopoulos

  4. School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Fotios Dilmperis

  5. 2nd Department of Otorhinolaryngology-Head and Neck Surgery, Papageorgiou University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Konstantinos Garefis

  6. Department of Urology, 424 Army General Training Hospital, Thessaloniki, Greece

    Ioannis Tsikopoulos

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  1. Alexios Tsikopoulos
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Contributions

AT was the primary author. AF assisted the primary author with data extraction, study selection, and literature research, whereas FD was involved in quality assessment. KG, ΙΤ, and PK reviewed the final version of the manuscript. ST and KT provided methodological advice and critically reviewed and revised the manuscript. Finally, CS and ST supervised the study and provided guidance on specific scientific issues. All authors read and approved the final manuscript.

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Correspondence to Alexios Tsikopoulos.

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Tsikopoulos, A., Fountarlis, A., Tsikopoulos, K. et al. Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 279, 2245–2257 (2022). https://doi.org/10.1007/s00405-022-07294-x

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  • DOI: https://doi.org/10.1007/s00405-022-07294-x

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