Interval Tonsillectomy: 27 Cases of Peritonsillar Abscesses Managed in Medical College Hospital.

Background and objectives: Peritonsillar abscess (quinsy) is the most common deep infection of the head and neck. The surgical treatment whether abscess tonsillectomy or interval tonsillectomy should be done is a subject of controversy, which still remains unresolved. Setting: Dept. of ENT, Head and Neck Surgery, KVG Medical College, Sullia, Karnataka. Material and methods: This was a comparative case series analysis study done in our department during the study period of 54 months from January 2007 to June 2011. Twenty-seven patients with clinical features of peritonsillar abscess who underwent medical line of treatment with incision and drainage and later interval tonsillectomy were included in the study. Results: The mean age was 30.4 years, mean hospital stay during incision and drainage was 3.51 days. The patient turned up for surgery within a mean duration of 9.4 months. The mean blood loss during the procedure was 100.5 ml and the mean visual analog scale (VAS) scores after interval tonsillectomy were 4.78. Mild-to-moderate difficulty was seen during the dissection of the abscess scarred tonsillar bed. Conclusion: Interval tonsillectomy is the standard treatment for managing peritonsillar abscess in many institutions. We recommend interval method of tonsillectomy done after a minimum of six weeks after incision and drainage of the peritonsillar abscess.

Scalpel Cautery Adenotonsillectomy Done in a Case of Crouzon’s Syndrome.

Background/Objectives: Crouzon syndrome is characterized by premature closure of the cranial sutures, midface hypoplasia, orbital deformities and other associated abnormalities. Children with Crouzon syndrome frequently have obstructive sleep apnea due to the underdevelopment of the midface. Setting: Dept. of ENT, Head and Neck Surgery and Anesthesia, KVG Medical College, Sullia. Case report: A 12-year-old boy of Crouzon syndrome with chronic adenotonsillitis was managed by adenotonsillectomy under general anesthesia by scalpel cautery method. The boy responded well to surgery and the mild sleep disorder disappeared within a week uneventfully. Conclusion: Sleep disorders in this condition can be treated by improving the airway by selective procedures like midface advancement, mandibular expansion, adenotonsillectomy, uvulopalatopharyngoplasty, anterior tongue reduction and endoscopic tracheal granuloma excision.