Tonsil

Comparison of Helicobacter pylori colonization on the tonsillar surface versus tonsillar core tissue as determined by the CLO test

July 31, 2007    
article

Bijan Khademi, MD;
Nika Niknejad, MD;
Behrooz Gandomi, MD;
Firoozeh Yeganeh, MD

Abstract
We conducted a prospective study to determine the correlation between the presence or absence of Helicobacter pylori on the tonsillar surface and in the tonsillar core as determined by the Campylobacter-like organism (CLO) rapid urease enzyme test. Our study population was made up of 55 patients who underwent adenoidectomy, tonsillectomy, or both from December 2002 through April 2003 at Khalili Hospital in Shiraz, Iran. Of these 55 patients, 45 (82%) were positive and 10 (18%) were negative for H pylori colonization as determined by CLO testing. Analysis of samples obtained from individual patients revealed differences in H pylori colonization between tonsillar surface samples and the core tissue samples. Of 106 tonsils obtained from 53 patients who underwent adenotonsillectomy or tonsillectomy, H pylori was found on 56 tonsillar surface samples (53%) and 24 tonsillar core samples (23%); only 13 tonsils (12%) contained H pylori both on the surface and in the core. We conclude that a surface swab is neither specific nor sensitive as an indicator of the presence or absence of H pylori colonization in tonsillar core tissue.

Schwannoma of the tonsil

May 31, 2007     Byung-Joo Lee, MD, PhD; Soo-Geun Wang, MD, PhD; Jin-Choon Lee, MD, PhD; Il-Woo Lee, MD, PhD
article
Abstract

Between 25 and 48% of schwannomas have been reported to occur in the head and neck region; the acoustic nerve is involved in most cases. Schwannomas arising in the tonsil are extremely uncommon. We report a case of tonsillar schwannoma in a 23-year-old woman. We also review the literature on this rare entity.

Follicular dendritic cell sarcoma of the tonsil: A case report and literature review

March 31, 2007     Chad McDuffie, MD; Timothy S. Lian, MD; Joel Thibodeaux, MD
article
 

Bilateral peritonsillar abscesses: A challenging diagnosis

March 1, 2007     James T. Edinger, MD; Elias Y. Hilal, MD; Khurshed J. Dastur, MD
article
 

An outpatient medical treatment protocol for peritonsillar abscess

September 30, 2006     Roland H. Lamkin, MD, FACS; James Portt, PAC, MMS
article
Abstract
Several surgical methods are used to treat peritonsillar abscess, but no protocol for outpatient medical treatment has yet been published. Between February 2002 and February 2005, we treated 98 peritonsillar abscess patients with an outpatient medical regimen that involved hydration, antibiotics, steroids, and good pain control. All patients were Native Americans, who are known to have a particularly high incidence of peritonsillar abscess. The medical regimen was generally successful, as only 4 patients (4.1%) subsequently required post-treatment needle aspiration or incision and drainage. We conclude that the medical protocol described herein provides practitioners with a viable noninvasive alternative for treating peritonsillar abscess.

Malignancy in asymmetrical but otherwise normal palatine tonsils

September 30, 2006     Adenike F. Oluwasanmi, FRCS; Stephen J. Wood, FRCS; David L. Baldwin, FRCS; Fabian Sipaul, MRCS
article
Abstract
An abnormally large tonsil may be a sign of malignancy. We retrospectively analyzed the case files of 87 patients who had asymmetrically sized but otherwise normal tonsils and no risk factors for cancer to determine if asymmetry is associated with a higher incidence of malignancy. We found 2 cases (2.3%) of malignancy among these patients. One patient had high-grade non-Hodgkin's lymphoma in the larger tonsil, and the other had lymphocyte-rich Hodgkin's lymphoma. Both patients were older than 50 years, and neither had a history of recurrent tonsillitis. We believe that although the incidence of cancer in our series was small, it is significant. Therefore, we recommend routine excision of abnormally large tonsils. Moreover, when making such a recommendation to a patient, it is essential that the patient have a clear understanding of the risk and benefit of having a tonsil removed solely because of asymmetry.

The submucosal fish bone

July 31, 2006     Patrick M. Spielmann, MBChB, MRCS (Edin); Conroy Howson, FCS (SA) ORL
article

Parathyroid adenoma mimicking cervical recurrence on CT/PET fusion scan

February 1, 2006     Sofia Avitia, MD; Ryan F. Osborne, MD, FACS
article

Bilateral peritonsillar abscess revisited

December 1, 2005     Adnan Safdar, FRCS; Joseph P. Hughes, FRCS; Rory McConn Walsh, FRCS; Michael Walsh, FRCS
article
Abstract
Bilateral peritonsillar abscess is uncommon. When it does occur, patients usually present with sore throat; other clinical signs and symptoms may differ from those usually associated with unilateral peritonsillar abscess. We describe 2 cases of bilateral peritonsillar abscess that were successfully treated with needle aspiration of both sides with a 14-gauge intravenous cannula. Needle aspiration is an accepted form of treatment for unilateral peritonsillar abscess, but to the best of our knowledge, its use as a sole treatment modality (with observation under intravenous antibiotic coverage) for bilateral peritonsillar abscess has not been previously reported in the literature. We also believe that the incidence of acute bilateral peritonsillar abscess may be higher than the rates that have been reported in the literature. Finally, we recommend that the threshold for imaging be low for any patient who is suspected of having acute bilateral peritonsillar abscess to avoid any delay in diagnosis and treatment.

Surgical emphysema following tonsillectomy

September 30, 2005     Nitesh Patel, FRCS; Gerald Brookes, FRCS
article
Abstract
Complications of tonsillectomy have been well documented. However, subcutaneous emphysema of the neck following tonsillectomy has rarely been described. We report a case of this complication in a young man who forcefully performed Valsalva's maneuver following a tonsillectomy.

Tonsillectomy without headlights: A unique solution

August 31, 2005     Narayanan Prepageran, FRCS; Rahmat Omar, MS; Rajagopalan Raman, MS, DLO
article

Peritonsillar abscess: A comparison of outpatient IM clindamycin and inpatient IV ampicillin/sulbactam following needle aspiration

May 31, 2005     Cem Ozbek, MD; Erdinc Aygenc, MD; Evrim Unsal, MD; Cafer Ozdem, MD
article
Abstract
In an attempt to assess the effect of antibiotic choice on the treatment of peritonsillar abscess, we compared the clinical efficacy of empiric intramuscular clindamycin and intravenous ampicillin/sulbactam (following needle aspiration of the abscess) in a prospective, randomized study of 58 patients. Patients in the clindamycin group were treated on an outpatient basis, whereas those in the ampicillin/sulbactam group were hospitalized for the duration of their treatment (minimum: 7 days). Comparison of clinical outcomes with respect to the posttherapeutic duration of fever and throat pain and the time to resumption of eating revealed no statistically significant difference between the two groups. These results suggest that intramuscular clindamycin is an excellent choice and can be safely prescribed on an outpatient basis following needle aspiration, thereby reducing both antibiotic and hospital costs.
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