既往扁桃体部分切除术后的扁桃体周围脓肿：一种潜在的长期风险
Peritonsillar Abscess Status Post Prior Tonsillotomy: A Potential Long-Term Risk.
文献信息
| PMID | 42891587 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Brandon Lee |
| 作者单位 | Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 手术切除扁桃体后发生扁桃体周围脓肿（PTA）是一种不常见的并发症。与扁桃体切除术相比，扁桃体部分切除术后残留的淋巴组织可能增加这一风险。本研究旨在识别儿童人群中扁桃体部分切除术或扁桃体切除术后发生PTA的病例，并比较其发生率及病例详情。
研究设计： 回顾性比较病例系列。
地点： 三级儿童医院。
方法： 对2010年1月至2025年1月期间接受扁桃体部分切除术或扁桃体切除术、且随后出现PTA的≤18岁患者进行回顾性分析。在实施的5576例扁桃体部分切除术和19834例扁桃体切除术中，识别出10例在研究机构扁桃体手术后发生PTA且病历资料完整的患者。
结果： 9例PTA发生于扁桃体部分切除术后（0.16%），1例发生于扁桃体切除术后（0.005%）。从扁桃体手术至PTA诊断的平均间隔（±SD）为8.2±3.0年（范围1-12年）。PTA诊断时的平均年龄为13.7±2.3岁（范围10-18岁）。10例患者中有7例确认存在残留扁桃体组织；5例接受了修正性扁桃体切除术。
结论： 扁桃体部分切除术相对于扁桃体切除术在短期术后并发症方面的优势已得到充分证实。尽管残留淋巴组织继发PTA的长期风险较低，但耳鼻咽喉科医生在术前就囊内扁桃体部分切除术与囊外扁桃体切除术进行咨询时，以及在治疗有既往囊内扁桃体部分切除术史的咽部症状患者时，应意识到这一可能的结果。
证据等级： 4级（病例系列）。
英文摘要
OBJECTIVE: Peritonsillar abscess (PTA) after surgical tonsil removal is an infrequent complication. Residual lymphoid tissue after tonsillotomy may increase this risk compared to tonsillectomy. This study aimed to identify cases of PTA following tonsillotomy or tonsillectomy in a pediatric population and compare the incidence and case details.
STUDY DESIGN: Retrospective comparative case series.
SETTING: Tertiary pediatric hospital.
METHODS: A review was conducted of patients ≤18 years of age who underwent tonsillotomy or tonsillectomy from January 2010 to January 2025 and later presented with PTA. Among 5576 tonsillotomies and 19,834 tonsillectomies performed, 10 patients were identified in whom PTA occurred after tonsil surgery at the study institution, and for whom complete medical records were available.
RESULTS: Nine cases of PTA occurred after tonsillotomy (0.16%) and one after tonsillectomy (0.005%). The mean interval (±SD) from tonsil surgery to PTA diagnosis was 8.2 ± 3.0 years (range, 1-12 years). Mean age at PTA diagnosis was 13.7 ± 2.3 years (range, 10-18 years). Residual tonsillar tissue was confirmed in seven of ten patients; five underwent revision tonsillectomy.
CONCLUSION: The benefits of tonsillotomy over tonsillectomy with respect to short-term postoperative morbidity are well established. Although the long-term risk of PTA secondary to residual lymphoid tissue is low, otolaryngologists should be aware of this possible outcome when counseling patients preoperatively as to intracapsular tonsillotomy versus extracapsular tonsillectomy, and when treating patients with pharyngeal symptoms with a history of prior intracapsular tonsillotomy.
LEVEL OF EVIDENCE: 4 (Case series).