Feasibility of an inexperienced examiner using trans-cervical ultrasound in the diagnosis of peritonsillar abscesses

Abstract

Background

A peritonsillar abscess (PTA) is a common complication to acute tonsillitis. Needle aspiration (NA) is the gold standard for diagnosis of PTA. NA is usually painful and not risk-free. Ultrasound (US) is a noninvasive, portable radiological modality that could potentially be used in the diagnosis of PTA and selection of patients for NA. The reliability of US is dependent on the experience of the examiner which limits is usefulness.

Aim

To evaluate the reliability of US in the diagnosis of PTA by an inexperienced examiner.

Methods

Thirty patients with suspected PTA were included. They were first examined with trans-cervical US by a medical student then clinically examined by a physician that performed a NA if clinically motivated. They were then followed for at least two days.

Results

Three patients were excluded from analysis because no NA was performed. In these patients, US correctly classified them as negative for PTA. In the remaining 27 patients, the sensitivity and negative predictive value was 100%. The specificity was 64.3% and the positive-predictive value was 72.2%.

Conclusion

US can be very useful in the diagnosis of PTA and the selection for NA even with an inexperienced examiner.

Significance

The results highlight the usefulness of ultrasound in otolaryngology.

Chinese abstract

背景：扁桃体周围脓肿（PTA）是急性扁桃体炎的常见并发症。针吸（NA）是诊断 PTA 的金标准。 NA 通常是痛苦的, 且并非没有风险。超声波(US) 是一种无创的便携式放射学方式, 可用于诊断PTA 和选择可接受NA的患者。超声波的可靠性取决于检测员的经验, 以限制它的使用。

目的：评估由缺乏经验的检测者用超声波诊断 PTA时, 超声波的可靠性。

方法：包括30名疑似PTA患者。他们首先由一名医科学生进行经颈部超声波检查, 然后由医生进行临床检查。如果有临床原因, 医生会进行 NA。然后他们被观察了至少两天。

结果：三名患者因未经 NA而被排除在分析之外。对于这些患者, 超声波检查正确地将它们归类为 PTA 阴性。对于其余 27 名患者, 敏感性和阴性预测值为 100%, 特定性为64.3%, 阳性预测值为72.2%。

结论：即使检查者没有经验, 超声波在 PTA 诊断和 NA 选择方面也非常有用。

意义：研究结果突出了超声波对于耳鼻喉科的有用性。

Keywords:

• Peritonsillar abscess
• ultrasound
• diagnosis
• needle aspiration

Disclosure statement

No potential conflict of interest was reported by the author(s).