Incision and Drainage of a Peritonsillar Abscess

What is a peritonsillar abscess?

• A collection of pus trapped between the tonsil and nearby muscle - making the abscess a peritonsillar (around the tonsil) abscess.
• This collection of pus is usually the result of a tonsil or throat infection - most commonly caused by Streptococcus, Staphylococcus, or other respiratory bacteria.
• This collection of pus has become walled off by a barrier that no longer lets antibiotic medication reach the infection.

Why does my child need their peritonsillar abscess drained?

• In most cases, symptoms have not improved after antibiotic treatment which means the medicines are not able to penetrate the abscess and treat the infection inside. Sometimes the abscess is so large even before medicines are used that the ENT surgeon determines drainage will be needed.
• This means that if the pus isn’t physically removed, the infection may spread to other parts of the mouth, neck, and chest and make it difficult for your child to breathe.

How is the peritonsillar abscess drained?

• This procedure is performed by and ear, nose, and throat surgeon. This procedure is commonly referred to as an I & D or incision and drainage.
• A small incision is made inside of your child’s mouth in front of the infected tonsil. The pus is drained out through this small opening.
• For some children, this procedure may be performed without anesthesia or sedation.
• For many children, this procedure is performed in the operating room with general anesthesia. This means your child will be fully asleep and carefully monitored during this procedure. You will have a chance to talk with the anesthesiologist on the day of surgery to discuss any questions you may have about the safety and risks of anesthesia.

What can I suspect after surgery?

• The small incision is left open to allow the infection to continue to drain. The cut will heal within three to five days.
• Close monitoring in the hospital with supportive cares including pain medication, hydration, and antibiotic therapy. Some children may be able to go home the same day following their procedure; this will be determined by your surgeon.
• Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen
• Once your child is ready to be discharged home care instructions may include:
  • Oral antibiotics to complete a 7 to 10 day course
  • Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen) as needed for pain management
  • Return to a normal diet as tolerated
  • Your child may return to school when he or she is feeling better.
  • A follow-up appointment with your primary care provider at the end of their antibiotic therapy course.

Should my child have the tonsils removed?

• If your child has a previous history of recurrent tonsillitis or a previous peritonsillar abscess, your ENT surgeon may recommend removal of the tonsils in the next two to three months to prevent recurrent infections. However, if this is the first time your child has had difficulty with a tonsil infection, further surgery is usually not necessary or beneficial.

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician. If you have any questions, please call Children’s ENT & Facial Plastic Surgery at 612-874-1292.

Reviewed 11/2022

 

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