Peritonsillar abscess drainage: using oropharyngeal endoscopy as a therapeutic adjunct and training tool.

BACKGROUND: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage. ISSUE: Inexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment. SOLUTION: To counter these and other difficulties, the authors describe the routine use of video endoscopy as a training tool and therapeutic adjunct in the management of quinsy.

Comparative analysis of conventional cold curettage versus endoscopic assisted coblation adenoidectomy.

OBJECTIVE: To compare conventional cold curettage adenoidectomy with endoscopic assisted coblation adenoidectomy in terms of operative time, primary blood loss, post-operative residual tissue and post-operative pain. METHODS: This prospective non-randomised study was carried out on 60 patients aged 5-12 years. One group underwent conventional cold curettage adenoidectomy and the other underwent endoscopic assisted coblation adenoidectomy, with 30 patients per group. RESULTS: Mean operation duration was significantly higher for endoscopic assisted coblation adenoidectomy. Mean blood loss was 44.33 ml in conventional cold curettage adenoidectomy and 32.47 ml in endoscopic assisted coblation adenoidectomy. The pain grade was significantly lower in endoscopic assisted coblation adenoidectomy. Forty per cent of patients who underwent conventional cold curettage adenoidectomy had adenoid tissue post-surgery, while it was completely absent in endoscopic assisted coblation adenoidectomy patients. CONCLUSION: Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of reduced blood loss, no post-operative residual tissue and lower pain grade on day 1 after surgery.