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Incision and drainage abscess; peritonsillar

CPT4 code

Name of the Procedure:

Incision and Drainage Abscess; Peritonsillar
Common names: Peritonsillar abscess drainage, Quinsy drainage

Summary

Incision and drainage of a peritonsillar abscess is a procedure where a doctor makes a small cut to remove pus from an infected, swollen area near the tonsils. This helps to relieve pain and treat the infection.

Purpose

This procedure addresses a peritonsillar abscess, often resulting from tonsillitis. The goals are to alleviate pain, reduce infection, and prevent complications such as difficulty breathing or swallowing.

Indications

  • Severe sore throat and difficulty swallowing
  • Swelling near the tonsils
  • Difficulty opening the mouth
  • Fever and chills
  • A "hot potato" voice (muffled voice)

Preparation

  • The patient may need to fast for several hours before the procedure.
  • Inform the doctor of all medications and allergies.
  • Pre-procedure assessments may include blood tests and a throat examination.

Procedure Description

  1. The patient is seated and given a local anesthetic to numb the area.
  2. The doctor uses a needle or small scalpel to make an incision in the swollen area near the tonsils.
  3. Pus is drained from the abscess.
  4. The area may be flushed with a saline solution.
  5. A suction device might be used to remove any remaining fluid.

Tools and equipment:

  • Scalpel or needle
  • Suction device
  • Saline solution

Anesthesia:

  • Local anesthesia is typically used. Sedation may be considered for anxious patients.

Duration

The procedure usually takes about 15-30 minutes.

Setting

This procedure is typically performed in an outpatient clinic or a hospital.

Personnel

  • ENT (Ear, Nose, and Throat) specialist or surgeon
  • Nurse
  • Anesthesiologist (if sedation is required)

Risks and Complications

  • Pain and bleeding at the incision site
  • Infection
  • Recurrence of the abscess
  • Rarely, damage to surrounding tissues and structures

Benefits

  • Quick relief from pain and swelling
  • Treatment of the infection
  • Prevention of complications such as airway obstruction

Recovery

  • Patients may need to rest for a few hours post-procedure.
  • Pain management with prescribed medication.
  • Follow-up appointment to ensure proper healing.
  • Avoid strenuous activities for a few days.

Alternatives

  • Antibiotics: Less invasive, but might not be enough if the abscess is large.
  • Needle aspiration: Less invasive but may not drain all the pus.
  • Tonsillectomy: Permanent removal of tonsils but involves more recovery time.

Patient Experience

  • Mild discomfort or pain during the procedure despite local anesthesia.
  • Immediate relief from pressure upon drainage.
  • Sore throat and mild pain for a few days post-procedure, manageable with painkillers.
  • Advice on maintaining hydration and a soft food diet temporarily.

Pain management and comfort measures:

  • Local anesthesia is used to minimize discomfort during the procedure.
  • Post-procedure pain is managed with medications and home care instructions.

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