How do you drain a Peritonsillar abscess?

Reviewed on 1/14/2021

Drainage of a peritonsillar abscess is a minor surgical procedure for treating a peritonsillar abscess (also known as quinsy). It is usually performed as an outpatient procedure, but you may be asked to get hospitalized if you have any other medical illness.
Drainage of a peritonsillar abscess is a minor surgical procedure for treating a peritonsillar abscess (also known as quinsy). It is usually performed as an outpatient procedure, but you may be asked to get hospitalized if you have any other medical illness.

The doctor will administer intravenous painkillers to drain your peritonsillar abscess. They may spray a numbing medication on your tonsils. This makes the surgical procedure painless or less painful for you.

  • The doctor’s assistant may retract your cheek laterally to improve visibility.
  • Your tongue will be pushed out of the way using a tongue depressor.
  • The doctor will identify the most prominent part of the abscess and inject about 3 mL of anesthetic into the tonsillar lining.
  • Using a needle attached to a syringe, the doctor will aspirate (draw in) a little quantity of pus and send it to the laboratory for examination under a microscope.
  • Next, the doctor will make a 0.5-cm incision over the most prominent area or location where needle aspiration (if done) identified pus on the tonsil.
  • The pus will start flowing, and you just spit it out.
  • A suction catheter is used to remove pus and blood.
  • You will be asked to rinse and gargle with saline or a dilute peroxide-saline solution.

What happens after draining a peritonsillar abscess?

You will be observed for 1 hour to check whether the tonsillar area has stopped bleeding. The doctor will also ask you if you can drink liquids comfortably.

You will be discharged on oral antibiotics and asked to do warm saline rinses. Follow-up will be scheduled after 24 hours.

If you have excessive bleeding or are unable to take oral antibiotics, you will be observed for several hours after the surgery.

If you have a history of multiple abscesses, your doctor may recommend a tonsillectomy after 4-6 weeks to prevent abscess recurrence.

Your doctor will ask you to continue the antibiotics for 7-10 days.

How is a peritonsillar abscess diagnosed?

Your doctor will ask you to open your mouth as widely as you can so that they can examine the inside of your mouth and throat. They will collect a sample of the pus from the abscess and send it to a laboratory to determine the bacteria that caused it.

The doctor will insert a long, flexible tube-like camera with light (endoscope) for clear visualization of your tonsils and the surrounding structures.

Doctors can often tell if you have a tonsillar abscess by examining your throat for

  • Red swollen tonsils with white patches.
  • Swelling of the uvula (the small piece of tissue hanging at the back of the throat).

To know the extent of the infection, your doctor may order an ultrasonography or a computed tomography (CT) scan of your neck region.

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What are the other treatments for a peritonsillar abscess?

Before considering the draining of the peritonsillar abscess, your doctor will first put you on antibiotics for 3-7 days. In mild cases, you can take the antibiotics in the form of pills. If the infection is severe, your doctor will administer the antibiotics through your vein.

If tonsillitis or a peritonsillar abscess keeps coming back (even after draining), your doctor may recommend a tonsillectomy, which is the surgical removal of your tonsils.

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References
Tonsillitis and Peritonsillar Abscess. Available at: https://emedicine.medscape.com/article/871977-overview

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