The use of sonography in the radiation diagnostics of peritonsillar abscesses

Peritonsillar abscess is an urgent disease. This condition requires immediate surgical treatment, while it is worth remembering that peritonsillar abscess is the final point of the peritonsillitis pathogenesis, and the latter should be treated nonoperatively. Clinical manifestations, complaints, pathogenetic stages do not usually intercorrelate, and the formation of a peritonsillar abscess occurs in 3-5 days on average. Reliability and confirmation of the diagnosis of peritonsillar abscess before physical examination are extremely limited: sensitivity is 78%, specificity — 50%. In clinical practice, in addition to physical examination, supplementary methods can be used: peritonsillar fine needle aspiration, CT and MRI. Peritonsillar fine needle aspiration has from 10 to 24% false-negative results, which is insufficient for the differentiation of peritonsillitis from peritonsillar abscess. According to some authors, computed tomography has high sensitivity and specificity for peritonsillar abscess, but computed tomography cannot be used routinely because of the radiation exposure risks. Magnetic resonance imaging is also used to diagnose inflammatory diseases of the head and neck. Soft tissues, fluid masses and large vessels are clearly visualized with MRI. On the other hand, it is important to be aware of the disadvantages and contraindications to the use of MRI in various clinical situations. MRI is significantly more costly than CT and it is not available around the clock in most hospitals. Crucially, the safety of using MRI during pregnancy has not been fully proven. In addition to the above methods, ultrasound, which is an available, minimally invasive, low-cost method, can be used for the diagnosis and differential diagnosis of peritonsillar abscesses. Ultrasound can be used to assist in the fine needle aspiration of peritonsillar abscesses.
Key words: peritonsillitis, peritonsillar abscess, sonography, computed tomography, magnetic resonance imaging, pharyngeal disorders, urgent care
Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study.