Method for predicting the course of peritonsillar abscess in patients with exacerbation of chronic tonsillitis

Objectives clinical and laboratory examination of patients with acute tonsillitis for early diagnosis and prognosis of peritonsillar abscess. Material and methods. The study included 101 patient with lacunar tonsillitis complicated by peritonsillar abscess and 64 donors (control group). Immunological studies were performed according to WHO recommendations, on the basis of the immunological department of the EMB Research Institute and the immunological laboratory of the SamSMU. Results. Immunological examination of patients with abscess showed an increase in: neutrophil phagocytic activity, CD4+/CD8+, the number of cells expressing HLA-DR+ markers, complement activity, IgA, IgM, IgG plasma concentration, fibronectin level, pro-inflammatory cytokines IL-8, IL-1, IL-1 and a decrease in: the level of TNF-, myeloperoxidase activity, number of cells containing CD4+, CD8+, CD16+, CD20+, CD25+ markers. High correlation was registered between total lymphocytes and CD3+ and CD4+ cells (p 0.01); between CD3+ and CD4+ markers (p 0.01); as well as high correlation of IL-1 levels with IL-8 and IL-1 (p 0.01). Cluster analysis revealed different types of immune homeostasis. The first type (cluster) had high values of leukocytes (total), lymphocytes (total), cells with CD3+, CD4+, CD8+, CD16+, CD20+, CD95+ and HLA-DR+ markers; the second type (cluster) was characterized by significantly lower levels of these immune status indicators. 41 patient had the first type of immune response, with an explicit clinical picture and rapid formation of an abscess. The second type of immune response was registered in 60 patients having a torpid course of the disease with delayed development of abscess. Further, to assess the type of immune reactions, it is necessary to substitute the values of indicators into the model and calculate the integral coefficient of the body's reaction (ICTROI and ICTROII).

Peritonsillar Abscess Treatment under Local Anaesthesia: Incision and Drainage versus Needle Aspiration

Background: Peritonsillar abscess is usually complication of acute tonsillitis which itself is prevalent in society. As a general surgical principle, abscess any were, has to be drained so same applies for quinsy but methodology for this drainage is not being agreed. Aim: To find best modality for drainage of this abscess and see its incidence in which age group and sex. Study design: Prospective study Place and duration of the study: Department of ENT, Rai Medical College, Sargodha from 1st Feb. 2017 to 31st Jan. 2019. Methodology: One hundred and thirty five patients above 15 years of age and those in need of hospital admission due to severity of symptoms were included. Paediatric, immunocompromised, requiring general anesthesia and acute tonsillitis patients were excluded. Results: There were 65.2% males and 34.8% females. Commonly affected age group was 21-40 years. Needle aspiration was found more effective for management of peritonsillar abscess. Conclusion: No consensus for single modality and both needle aspiration and incision/drainage is advocated and needle aspiration proved fruitful in management. Keywords: Quinsy, Peritonsillar abscess, needle aspiration