The value of transcutaneous ultrasound in the diagnosis of tonsillar abscess: A retrospective analysis

Sievert M, Miksch M, Mantsopoulos K, Goncalves M, Rupp R, Mueller SK, Traxdorf M, Iro H, Koch M (2021)

Publication Type: Journal article

Publication year: 2021

Journal

DOI: 10.1016/j.anl.2021.04.006

Abstract

Objective: To identify the appropriate treatment in the tonsillar region's infections, a distinction between tonsillitis with or without abscess formation is essential. Ultrasound proved to be a valuable method in identifying abscess formation in the head and neck region. However, no report described the assessment of the tonsil region. This study aims to determine the feasibility of transcervical ultrasound for abscess visualization in the palatal tonsillar region. Methods: Retrospective analysis of 354 patients presenting with clinical suspicion of tonsillar abscess to a tertiary referral center and university hospital. All patients received a transcervical ultrasound to establish a primary diagnosis. The existence of an abscess was confirmed by puncture and incision, or final tonsillectomy. If no abscess could be delineated, non-abscessing tonsillitis was supposed, and conservative primary therapy and closed follow-up examinations were performed. Results: After the first diagnostic ultrasound examination, in 257 cases (72.59%), the diagnosis of an abscess could be established, but in 97 cases (27.40%), due to missing abscess formation criteria, non-abscessing tonsillitis was documented. Overall, ultrasonography demonstrated an overall accuracy of 78.8% in this selected cohort. The sensitivity, specificity, PPV, and NPV after the first ultrasound examination were calculated with 75.1%, 88.6%, 94.6%, and 57.3%, respectively. Conclusion: The presented data confirm that an abscess formation due to tonsillitis can be detected by transcervical ultrasound, enabling prompt, adequate management. As transcervical ultrasound can be conducted fast and is not associated with radiation, it can be regarded as a first-line diagnostic tool in this condition.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Malin Miksch Department of Otorhinolaryngology – Head and Neck Surgery Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Maximilian Traxdorf Medizinische Fakultät Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Michael Koch Medizinische Fakultät

How to cite

APA:

Sievert, M., Miksch, M., Mantsopoulos, K., Goncalves, M., Rupp, R., Mueller, S.K.,... Koch, M. (2021). The value of transcutaneous ultrasound in the diagnosis of tonsillar abscess: A retrospective analysis. Auris Nasus Larynx. https://doi.org/10.1016/j.anl.2021.04.006

MLA:

Sievert, Matti, et al. "The value of transcutaneous ultrasound in the diagnosis of tonsillar abscess: A retrospective analysis." Auris Nasus Larynx (2021).

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