ULTRASOUND DIAGNOSTICS OF PARATONZILLAR ABSCESS
Rusetsky Yu.Yu.1, Elovikov V.A.1, Serova N.S.2, Shcheglov A.N.3,
Miroshnichenko A.P.4, Haddadin D.T.5
1 – Central State Medical Academy of Russian Federation President Administration. Moscow, Russia.
2 –Sechenov University. Moscow, Russia.
3 –Central Clinical Hospital with a Polyclinic department. Moscow, Russia.
4 – F.I. Inozemtsev City Clinical Hospital. Moscow, Russia.
5 – ENT-Center “SEZIM”. Astana, Kazakhstan.
Purpose. To study peritonsillar region syntopy during purulent pathology and in normal conditions. To determine and to describe the peritonsillar abscess ultrasound attributes.
Material and methods. A total of 130 people were included in the study. Participants were divided into 2 groups. Group No. 1 included 80 healthy people. We carried ultrasound examination of the peritonsillar region out in this group for visualization and description of permanent anatomical landmarks in this area. In addition, we determined spatial relationships between anatomical structures in the area. Group No. 2 included 50 patients with peritonsillitis attributes and peritonsillar abscess manifestations. In this group, peritonsillar region ultrasound examination of the affected side was performed. We evaluated relationships between the normal anatomical structures and pathological structures. The ultrasound examination was performed using linear transcutaneous probe 2.5 MHz, linear transcutaneous probe 8 MHz, linear transcutaneous probe 12 MHz, transcutaneous convex probe 3.5 MHz and intracavitary (intraoral) convex probe 6 MHz in both groups.
Results. Normal ultrasound semiotics of the peritonsillar region was described. The constant clinically significant anatomical landmarks were determined which included the internal carotid artery, palatine tonsil (in the absence of a history of tonsillectomy), submandibular salivary gland, tongue, and anterior belly of the digastric muscle. The listed structures were visualized in 100% of cases with any available ultrasound probes using. The ultrasound signs of a peritonsillar abscess were identified and described. An algorithm for ultrasound examination of the peritonsillar region has been developed and described.
Discussion. The sensitivity and specificity indices of ultrasound diagnostics in relation to peritonsillar abscess, obtained in the course of the study, moderately differed from the literature data. In most studies, the authors provide data on the sensitivity of ultrasound in relation to peritonsillar abscess from 89% to 92%. The data on specificity vary significantly, according to various authors, from 80% to 100%. We obtained sensitivity and specificity indices close to 100%. In addition, we calculated these indices for different types of ultrasound sensors: straight linear sensors 2.5 MHz, 8 MHz, 12 MHz, transcutaneous convex probe 3.5 MHz and intracavitary (intraoral) convex sensor 6 MHz. These data are necessary for selecting the optimal ultrasound sensor for use in clinical practice and optimizing the provision of medical care to patients with peritonsillar abscess.
Conclusion. Thus, ultrasound is a highly informative method for diagnosing pathology of the paratonsillar region, in particular paratonsillar abscess and paratonsillitis. Ultrasound examination allows us to determine the presence of a pathological focus, its relationship with surrounding structures, which allows us to optimize treatment tactics in patients with purulent pathology of the oropharynx. The most effective in the clinical practice of emergency medicine were the rectilinear transcutaneous probe 8 MHz and the convex transcutaneous probe 3.5 MHz.
Keywords: ultrasound diagnostics, peritonsillar abscess, ultrasound diagnostics, paratonsillitis.
Corresponding author: Elovikov V.A., email: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Rusetsky Yu.Yu., Elovikov V.A., Serova N.S., Shcheglov A.N., Miroshnichenko A.P., Haddadin D.T. Ultrasound diagnostics of paratonzillar abscess. REJR 2024; 14(3):111-121. DOI: 10.21569/2222-7415-2024-14-3-111-121.
Received: 15.05.24 Accepted: 11.09.24