Application of enhanced CT in the differential diagnosis of peritonsillar abscess and intratonsillar abscess / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the application of enhanced CT in the differential diagnosis and treatment of peritonsillar abscess (PTA) and intratonsillar abscess (ITA).</p><p><b>METHODS</b>Thirty-eight in-patients with clinically suspected PTA from June 2011 to June 2013 were included in this study. All these patients underwent enhanced CT scan for the throat region. According to CT results, the location of abscess was determined, and the thickness of the posterior wall of abscess as well as its distance with the internal carotid artery was calculated.Incision and drainage were then guided with this information.</p><p><b>RESULTS</b>Twenty-six of the 38 patients (68.4%) met the diagnosis of PTA, demonstrating a hypodense collection with rim enhancement in the peritonsillar space, including 4 cases with multilocular abscess. Ten cases (26.3%) should actually be diagnosed as ITA, with a abscess collection located in the palatine tonsil tissue. Two cases(5.3%) were diagnosed as peritonsillar cellulitis (PTC), showing diffuse isodense lesion around the peritonsillar space. The 26 cases of PTA and 10 cases of ITA patients were all cured using incision and drainage under the precise guidance of CT, while the 2 cases of PTC only treated with medicine. The mean distance between the posterior wall of abscess and the carotid artery (X(-) ± s) were (0.76 ± 0.34) cm and (0.90 ± 0.37) cm for the two entities respectively, with no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Enhanced CT scan can clearly demonstrate the characters of PTA and ITA, and make identification. Moreover, it is helpful for the determination of therapy, improving the success rate of drainage and reducing the potential risk of large artery injury.</p>