Clinical aspects of inferior pole peritonsillar abscess

Abstract In most peritonsillar abscess, the lesion is usually found in the superior pole of the palatine tonsil and typical symptoms such as trismus and resting of uvula are observed. On the other hand, inferior pole peritonsillar abscesses (IPPA) are rare and the symptoms are different from that of superior pole peritonsillar abscesses (SPPA). In the present study, the clinical aspects of patients with IPPA were compared with that of SPPA in order to clarify the characteristics of this disease. One hundred and six patients with peritonsillar abscess who were treated in our clinic between 1990 and 2002 were retrospectively investigated. The diagnosis of SPPA and IPPA was obtained by the findings of CT and during surgery. Among all patients, SPPA was found in 87% and IPPA, 13%. IPPA was more frequently observed in senior patients when compared with SPPA. Tonsil displacement and trismus were observed only in 25% and 17% of IPPA, respectively. The incidence of those symptoms was remarkably lower than that in SPPA. There was no significant difference in laboratory examinations between SPPA and IPPA. Bacteriological findings were quite different between IPPA and SPPA. Those results suggest that the pathogenesis of IPPA might be different from that of SPPA.