Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 May;279(5):2245-2257.
doi: 10.1007/s00405-022-07294-x. Epub 2022 Feb 15.

Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

Alexios Tsikopoulos  1 , Athanasios Fountarlis  2 , Konstantinos Tsikopoulos  3 , Fotios Dilmperis  4 , Konstantinos Garefis  5 , Ioannis Tsikopoulos  6 , Charalampos Skoulakis  2 , Petros Karkos  7 , Stefanos Triaridis  7
Affiliations
Meta-Analysis

Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

Alexios Tsikopoulos et al. Eur Arch Otorhinolaryngol. 2022 May.

Abstract

Objectives: Peritonsillar abscess is a common complication of acute tonsillitis. However, no consensus has been reached yet on the optimal treatment of this condition. Therefore, this study aimed to compare clinical outcomes of immediate and interval abscess tonsillectomy.

Methods: The databases of PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for completed studies published until the 1st of November 2021. Comparative studies assessing intraoperative and postoperative outcomes of immediate and interval abscess tonsillectomy were considered, with the primary outcome being postoperative hemorrhage. Operative time, intraoperative blood loss, postoperative pain, and duration of hospital stay were classed as secondary outcomes. A random-effects pairwise meta-analysis of both randomized and non-randomized trials was conducted. Subgroup analysis linked to the randomization of trials was executed. Quality assessment was performed, utilizing the Cochrane risk of bias tool and ROBINS-I tool for randomized and non-randomized trials, respectively.

Results: Data from 265 cases stemming from six trials were pooled together. For postoperative bleeding rates, no statistically significant difference between immediate and interval tonsillectomy was detected (OR = 1.26; 95% CI 0.27, 5.86; p = 0.77). By contrast, longer hospital stay was observed for patients subjected to interval tonsillectomy (SMD = - 0.78; CI - 1.39 to- 0.17; p = 0.01). For operative time and intraoperative blood loss, no statistically significant difference was noticed between immediate and interval tonsillectomy (SMD = 1.10; 95% CI - 0.13, 2.33; p = 0.08; and SMD = 0.04; 95% CI - 0.49, 0.57; p = 0.88; respectively).

Conclusions: This study shows that quinsy tonsillectomy appears to be a safe method, providing full abscess drainage and instant relief of the symptoms. Moreover, quinsy tonsillectomy was not associated with a statistically higher postoperative hemorrhage incidence rate than immediate tonsillectomy.

Keywords: Meta-analysis; Peritonsillar abscess; Quinsy; Systematic review; Tonsillectomy; Tonsillitis.

PubMed Disclaimer

Comment in

References

    1. Khan MA, Ahmed A, Khan M (2020) Comparison of early versus interval tonsillectomy in cases of peritonsillar abscess. Life Sci 1(1):5 - DOI
    1. Simon LM, Matijasec JWD, Perry AP, Kakade A, Walvekar RR, Kluka EA (2013) Pediatric peritonsillar abscess: quinsy ie versus interval tonsillectomy. Int J Pediatr Otorhinolaryngol 77(8):1355–1358 - DOI
    1. Klug TE, Rusan M, Fuursted K, Ovesen T (2016) Peritonsillar abscess: complication of acute tonsillitis or webers glands infection? Otolaryngol—Head Neck Surg (United States) 155(2):199–207 - DOI
    1. Lockhart R, Tami TA, Parker GS (1991) Role of quinsy tonsillectomy in the management of peritonsillar abscess. Ann Otol Rhinol Laryngol 100(7):569–571 - DOI
    1. Fagan JJ, Wormald PJ (1994) Quinsy tonsillectomy or interval tonsillectomy—a prospective randomised trial. S Afr Med J 84(10):689–690. PMID: 7839259 - PubMed

MeSH terms

LinkOut - more resources