Korean J Otorhinolaryngol-Head Neck Surg.  2018 Feb;61(2):99-102. 10.3342/kjorl-hns.2017.01025.

Diagnosis and Treatment of Peritonsillar Abscess with Single Enhanced Computed Tomography

• Song K
• Lee J
• Choi SY
• Choi MS

• KMID: 2436432
• DOI: http://doi.org/10.3342/kjorl-hns.2017.01025

Abstract

BACKGROUND AND OBJECTIVES
Diagnostic features of peritonsillar abscess are an asymmetrically enlarged palatine tonsil with peripheral rim enhancement and central low density in the post-contrast computed tomography (CT). Although it is necessary to differentiate tumorous conditions of tonsils to compare pre- and post-contrast CT, pre-contrast CT may be less useful in the diagnosis of peritonsillar abscess. This study aims to evaluate of the efficacy of single post-contrast CT for diagnosis and treatment of peritonsillar abscess.
SUBJECTS AND METHOD
We retrospectively compared 29 patients with peritonsillar abscess, who were diagnosed by single post-contrast CT, with 36 patients diagnosed by pre- and post-contrast CT to determine the success rates of pus drainage and hospital days. Additionally, two otorhinolaryngologists made a judgment of abscess presence for sixty randomly mixed CT images of peritonsillar abscess or tonsillitis with pre- and post-contrast CT or single post-contrast CT.
RESULTS
There were no significant differences in the success rate of drainage (p=0.622) and hospital days (p=0.504) between groups with/without pre-contrast CT. Abscess presence was judged by raters with/without pre-contrast CT. Inter-rater agreement value (Cohen's kappa) was 0.825 (p<0.01).
CONCLUSION
Single post-contrast CT of peritonsillar abscess may be a good alternative for diagnosis and treatment and may reduce unnecessary exposure to radiation.

Keyword

Computed tomography; Contrast media; Peritonsillar abscess; Sensitivity; Specificity

MeSH Terms

Abscess
Contrast Media
Diagnosis*
Drainage
Humans
Judgment
Methods
Palatine Tonsil
Peritonsillar Abscess*
Retrospective Studies
Sensitivity and Specificity
Suppuration
Tonsillitis
Contrast Media