Transoral Ultrasound in the Diagnostic Workup of Peritonsillar Abscess-A Randomized Clinical Trial.
Tobias Todsen, Mads G Stage, Jacob Melchiors et al.
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In 30 seconds
This multicenter randomized clinical trial assessed whether adding transoral ultrasound to standard examination improves the diagnostic workup of patients suspected of having peritonsillar abscess. Ninety-five patients at two Danish hospitals were assigned to standard examination with or without ultrasound. Diagnostic accuracy was 80.9% with ultrasound versus 72.9% with standard examination (p = 0.50), with no significant improvement. Ultrasound use was associated with 31.9% fewer needle aspiration attempts (p < 0.01), although the trial found no improvement in patient outcomes.
Key findings
- Diagnostic accuracy was 80.9% with ultrasound versus 72.9% with standard examination (p = 0.50).
- The ultrasound group underwent 31.9% fewer needle aspiration attempts than the control group (p < 0.01).
- Unsuccessful aspirations occurred in 12 (26.0%) intervention patients and 18 (37.5%) control patients.
Why it matters
Distinguishing peritonsillar abscess from cellulitis can be difficult, and diagnostic aspiration may be unsuccessful. In this randomized trial, transoral ultrasound reduced the number of aspiration attempts, suggesting a potential procedural benefit. However, it did not significantly improve diagnostic accuracy or patient outcomes, so the findings do not establish broader clinical benefit.
What to keep in mind
The trial included 95 patients at two hospitals; it found no significant improvement in diagnostic accuracy or patient outcomes.