Autopsy of paratonsillar abscess

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What is a paratonsillar abscess?

Paratonsillar abscess - acute inflammation of the surrounding tonsils with the formation of a cavity filled with pus. Appears as a result of the spread of the inflammatory process from the tonsils. It can be unilateral or bilateral.

When can a paratonsillar abscess be suspected?

As a rule, paratonsillar abscess can develop within the first 3 to 4 days after the onset of acute bacterial tonsillitis (angina) or exacerbation of chronic tonsillitis, all very individual and depends on the state of the body's immune system.

In most cases, this process is accompanied by pronounced symptoms, including:

• severe sore throat that can give in the ear or teeth;
• feeling of a lump in the throat, difficulty swallowing and breathing;
• increase in body temperature to critical figures - 39-40 C;
• difficulty opening the mouth as a result of spasms of the masticatory muscles;
• pain in the neck when turning or tilting the head;
• enlargement of submandibular lymph nodes on one or both sides;
• general malaise: headache, general weakness.

How is a paratonsillar abscess diagnosed?

Diagnosis of the disease begins with pharyngoscopy - examination of the pharynx. At a paratonsillar abscess, the asymmetric change of a usual form of a throat due to a shift of a palatine tonsil in the middle from inflammation is observed. To clarify the prevalence of the inflammatory process below the tonsils, you may need a laryngoscopy - examination of the larynx using a camera. The doctor also conducts a detailed survey of the patient in order to identify the possible cause of the disease, the presence of chronic diseases, individual characteristics of the organism. If neck phlegmon is suspected, ultrasound, CT, or soft tissue MRI may be required in some cases with intravenous contrast if necessary.

How is a paratonsillar abscess dissected?

Before opening the abscess, if necessary, is performed diagnostic puncture - a puncture in a possible place of localization of purulent process. Then with the help of a scalpel make an incision of the mucous membrane in the area of the largest protrusion or a typical place under local anesthesia (10% lidocaine solution). In the cavity of the abscess is injected forceps or a clamp with which to dilute the tissue. Then the opened cavity is thoroughly washed with an antiseptic solution. Immediately after the outflow of pus, the patient's condition improves significantly: the temperature decreases, the pain subsides, the mouth opens better.

With a late diagnosis of paratonsillar abscess or lack of adequate treatment, the disease can lead to the development of sepsis, phlegmon of the neck, purulent mediastinitis, infectious-toxic shock, bleeding from the vessels of the neck, and other life-threatening complications.

How is the recovery period?

Opening of a paratonsillar abscess is a procedure that is performed on an outpatient basis in an outpatient setting. If only an abscess was opened, under local anesthesia, then after the procedure and the introduction of the necessary drugs, you can go home. If it is necessary to open the abscess at one time with the removal of the tonsils (abscess tonsillectomy), the patient is hospitalized for at least 24 hours. Recovery after surgery takes up to 3 weeks. After the operation, the doctor will prescribe you a day of a follow-up visit to assess the process of tissue healing and adjust further treatment.

What rules should be followed after the procedure?

After opening a paratonsillar abscess, the patient must follow these rules:

• it is forbidden to warm the neck because it will increase swelling and slow down healing;
• it is forbidden to drink excessively hot or cold drinks, so as not to cause severe local narrowing or dilation of blood vessels;
• it is desirable to eat semi-liquid or liquid food;
• during rehabilitation, it is forbidden to drink alcohol and it is desirable to refrain from smoking;
• to avoid complications it is necessary to take anti-inflammatory drugs, antibiotics prescribed by a doctor.