Acute Tonsillitis

Acute Tonsillitis

Acute Tonsillitis refers to inflammation of the pharyngeal tonsils. The inflammation usually extends to the adenoids and the lingual tonsils; therefore, the term pharyngitis may be used interchangeably. Pharyngotonsillitis and adenotonsillitis are considered equivalent for the purposes of this article. Lingual tonsillitis refers to isolated inflammation of the lymphoid tissue at the base of the tongue.

Peritonsillar abscess is the most common complication of acute tonsillitis and is the most common deep infection of the head and neck. It usually occurs in the second to third decade of life and, 70% to 80% of the time is predominantly located at the superior pole. It occurs when a localized infection spreads along the connective tissue septae of the tonsil into the loose areolar tissue of the peritonsillar space.

Since 1981, several large series have been published which study the efficacy of the needle aspiration technique versus incision and drainage for the outpatient treatment of peritonsillar abscess. Needle aspiration has several decided advantages. Incision and drainage are very painful as it is difficult to obtain local anesthesia in the presence of inflammation. Secondly, the abscess cavity may be in any of several locations or may be loculated making drainage very difficult.