National survey on peritonsillar abscess treatment and attitudes toward quinsy tonsillectomy.

Abstract

Objectives: Peritonsillar abscess (PTA) is a common deep neck infection traditionally managed with conservative measures. Quinsy Tonsillectomy (QT) is recognized as a definitive treatment but remains variably utilized. We aimed to investigate PTA management strategies and attitudes toward QT among otolaryngologists.

Methods: An anonymous questionnaire was distributed to members of the local national Society of Otolaryngology, evaluating treatment strategies based on patient characteristics and clinical scenario.

Results: A total of 108 otolaryngologists responded (response rate: 30.8%). Participants preferred to treat PTA patients as inpatients (89%) and predominantly offered incision and drainage (I&D) as the first (90.7%) and subsequent (98.1%) treatment plan. QT was favored as a primary treatment only in 1.9% of responders. QT adoption increased with multiple I&D failures, reaching 95.3% after four attempts. In patients with recurrent PTA or tonsillitis, 84.2% preferred I&D follows by interval elective tonsillectomy, while 15% considered QT. The most common reason (72.2%) to avoid QT was the perception of a high perioperative risk.

Conclusion: I&D was favored for initial PTA treatment. QT is considered after multiple failed I&D attempts, and its use is limited as a primary treatment, mainly due to concerns regarding perioperative risk.