Advertisement

Tonsils

  • Jennifer V. Huang
  • Kevin Hu
Chapter

Abstract

Peritonsillar abscess (PTA) is a complication of tonsillitis and other upper respiratory infections; it is the most common deep space infection that presents to the emergency department. Diagnosis is often challenging, and even among experienced otolaryngologists, clinical exam has been shown to be only 78% sensitive and 50% specific in diagnosis of this pathology. Sonography is used both diagnostically and to provide procedural guidance in real time.

Keywords

Peritonsillar abscess Intraoral ultrasound ENT Transcutaneous ultrasound Ultrasound guided drainage 

Supplementary material

Video 12.1

IOU ultrasound. This video demonstrates a peritonsillar abscess. Note the hypoechoic abscess in the center of the video. Video courtesy of Mikaela Baker (MP4 176 kb)

Video 12.2

IOU ultrasound. This video demonstrates a peritonsillar abscess. Note the hypoechoic abscess. Video courtesy of Ee Tay (MP4 184 kb)

Video 12.3

IOU ultrasound. This video demonstrates a peritonsillar area after drainage. Note that there is no longer hypoechoic fluid in the center of the peritonsillar area. Video courtesy of Ee Tay (MP4 183 kb)

Video 12.4

This video demonstrates a peritonsillar abscess using the telescopic submandibular approach. Video courtesy of Andrew Liteplo (MP4 759 kb)

Video 12.5

This video demonstrates an ultrasound guided needle aspiration of a PTA using a telescopic submandibular approach. Note the position of the needle as it approaches the abscess. Video courtesy of Andrew Liteplo (MP4 703 kb)

Video 12.6

This video demonstrates an ultrasound guided needle aspiration of a PTA using a telescopic submandibular approach. Note the position of needle in the center of the hypoechoic abscess. Video courtesy of Andrew Liteplo (MP4 637 kb)

Suggested Reading

  1. 1.
    Blaivas M, Theodoro D, Duggal S. Ultrasound-guided drainage of peritonsillar abscess by the emergency physician. Am J Emerg Med. 2003;21(2):155–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Costantino TG, Satz WA, Dehnkamp W, Goett H. Randomized trial comparing intraoral ultrasound to landmark-based needle aspiration in patients with suspected peritonsillar abscess. Acad Emerg Med. 2012;19(6):626–31.CrossRefPubMedGoogle Scholar
  3. 3.
    Kew J, Ahuja A, Loftus WK, Scott PM, Metreweli C. Peritonsillar abscess appearance on intra-oral ultrasonography. Clin Radiol. 1998;53(2):143–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Lyon M, Blaivas M. Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department. Acad Emerg Med. 2005;12(1):85–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Prokofieva A, Modayil V, Chiricolo G, Ash A, Raio C. Ultrasound-guided drainage of peritonsillar abscess: shoot with your hockey-stick. Intern Emerg Med. 2016;11(6):883–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Rehrer M, Mantuani D, Nagdev A. Identification of peritonsillar abscess by transcutaneous cervical ultrasound. Am J Emerg Med. 2013;31(1):267.e1–3.CrossRefGoogle Scholar
  7. 7.
    Scott PM, Loftus WK, Kew J, Ahuja A, Yue V, van Hasselt CA. Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis. J Laryngol Otol. 1999;113(3):229–32.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Ungkanont K, Yellon RF, Weissman JL, Casselbrant ML, González-Valdepeña H, Bluestone CD. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg. 1995;112(3):375–82.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jennifer V. Huang
    • 1
  • Kevin Hu
    • 1
  1. 1.Department of Emergency MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA

Personalised recommendations