Clinical factor for successful nonsurgical treatment of pediatric peritonsillar abscess.

Abstract

OBJECTIVES/HYPOTHESIS:

Current management for peritonsillar abscess in pediatric patients includes intensive medical therapy using antibiotics with or without surgical drainage. However, attaining proper surgical drainage is difficult in young children because they have narrow oral cavities and are less cooperative than adults. The aim of this study was to investigate which factors are associated with a good response to nonsurgical treatment of a pediatric peritonsillar abscess.

STUDY DESIGN:

A retrospective analysis.

METHODS:

This study included consecutive children who visited our pediatric clinic for the treatment of peritonsillar abscess. All patients initially received medical treatment, and additional surgical treatment was provided if the patient appeared unlikely to recover. Multivariate logistic regression models were constructed to identify factors associated with a good response to nonsurgical treatment. In addition, a receiver operating characteristic curve was used to identify the age cutoff for predicting good treatment response.

RESULTS:

A total of 88 children were included the study. Patient age, recurrent tonsillitis, and abscess size were significantly associated with response to nonsurgical treatment (adjusted odds ratios=1.485, 2.403, and 1.325, respectively) after adjusting for sex, body mass index, season, serum C-reactive protein levels, and tonsil grade. The age cutoff associated with good response to nonsurgical treatment was 7.5 years (80.0% sensitivity, 51.5% specificity).

CONCLUSION:

Our findings suggest that a younger age, fewer episodes of acute tonsillitis, and smaller abscess size predict a successful response to nonsurgical treatment in children with peritonsillar abscess.

LEVEL OF EVIDENCE:

4.

• Authors: Dong-Kyu Kim, Jung Woo Lee, Yoon Sung Na, Myung Jin Kim, Jun Ho Lee, Chan Hum Park
• Journal: The Laryngoscope (Laryngoscope) Vol. 125 Issue 11 Pg. 2608-11 (Nov 2015) ISSN: 1531-4995 [Electronic] United States
• PMID: 26152910 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Topics

• Acute Disease
• Age Factors
• Child
• Child, Preschool
• Female
• Humans
• Logistic Models
• Male
• Peritonsillar Abscess (complications, diagnostic imaging, epidemiology, therapy)
• ROC Curve
• Recurrence
• Retrospective Studies
• Tomography, X-Ray Computed
• Tonsillitis (etiology)
• Treatment Outcome