Changing face of treatment of peritonsillar abscess.

Changing trends in the treatment of peritonsillar abscess are demonstrated by this retrospective study of 74 patients treated from 1975 through 1980 by a standardized regimen. This included needle aspiration at three points, intravenous antibiotics, hydration, and pharyngeal douches. The patients ages ranged from 11 to 73 years. There were 45 males and 29 females. Needle aspiration was positive in 52 patients (70%) and repeat aspiration was necessary in 10% of patients. Tonsillectomy was performed in 42 patients. No recurrent peritonsillar abscesses occurred during the 1 to 5 year follow-up of the 32 patients who did not have tonsillectomy. Recurrent tonsillitis did occur in 4 of these patients and 3 of them had a past history of recurrent tonsillitis. The authors conclude that treatment of peritonsillar abscess should consist of needle aspiration, intravenous antibiotics and supportive measures. Interval tonsillectomy should be performed only when there is a history of recurrent tonsillitis or previous peritonsillar abscess.

Set-back tongue flap for carcinoma of the tongue base.

Carcinoma of the base of the tongue has been treated with various combinations of radiotherapy and surgery. Resection of this area poses a major problem in reconstruction because of the need for establishing normal physiologic characteristics. This article emphasizes the benefits of a lateral pharyngotomy and mandibulotomy for resection of large portions of the tongue base. We describe a tongue flap with a neurovascular pedicle that is set back into the tongue-base deficit. This one-stage procedure is relatively easy to perform and provides good physiologic results.