Tonsillectomy à chaud.

PERITONSILLAR abscess develops as a complication of tonsillitis, when infection spreads to the loose peritonsillar tissues. Insufficiently treated the abscess may perforate into the parapharyngeal space and spread along the vessels of the neck to the mediastinum or upwards under the base of the skull. Thrombophlebitis in the jugular vein, oedema of the larynx, sepsis and metastatic abscesses may be seen. Adequate drainage in an early stage is essential in order to avoid these serious complications. By tonsillectomy in the acute phase (tonsillectomy a chaud) complete drainage is obtained. However, this operation has been regarded as dangerous, thus Z0llner (1934) stated that the operation of tonsillectomy a chaud was not free from risk of spreading the infection and that it ought to be reserved for selected cases. Today there exist other conditions for performing tonsillectomy d chaud with regard to the method of operation, anaesthesia and treatment of infections. Bateman and Kodicek (1954), Grahne (1958) and Beeden and Evans (1970) have published optimistic results, of the use of tonsillectomy d chaud. In Scandinavia a conservative attitude (stab-incision and/or antibiotics) is still dominant and the purpose of this work is to investigate the advantages and disadvantages of the routine use of tonsillectomy a chaud for peritonsillar abscess.