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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
- The patient is seated and given a local anesthetic to numb the area.
- The doctor uses a needle or small scalpel to make an incision in the swollen area near the tonsils.
- Pus is drained from the abscess.
- The area may be flushed with a saline solution.
- 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.