Background: Peritonsillar abscess is a common clinical condition encountered in the practice of otolaryngology. However, there is no consensus yet in terms of best treatment of peritonsillar abscess. The current prospective clinical study was performed to compare two common treatments of peritonsillar abscess, namely, needle aspiration versus incision and drainage for peritonsillar abscess

Methods: A prospective study was performed on patients with diagnosis of peritonsillar abscess from January 2008 to December 2012. A total of 110 patients were enrolled in this study and were randomly allocated to two groups who were treated with needle aspiration and incision and drainage, respectively. Data collected included age, gender, clinical symptoms and treatment outcome.

Results: There were 98 males and 12 females ranging from 12 to 79 years of age, with mean age of 31.0 ± 15.0 years. Complete remission of symptoms was achieved for all patients during the follow-up. No significant difference was observed regarding baseline characteristics including age, gender, location of the abscess, and duration of symptoms between the two groups. Pain scores taken one and 24 hours after either procedure suggested that patients treated with needle aspiration felt less pain compared with those treated with incision and drainage. Additionally, no significant difference in the median hospital stay was found between the two groups. There were two (3.6%) patients in the needle aspiration group who required incision and drainage after two needle aspirations. No significant side effects were observed in either group.

Conclusions: The complication rate and length of hospital stay are similar between the needle aspiration and the incision and drainage groups. Needle aspiration is an efficient and safe procedure to treat peritonsillar abscess. Furthermore, needle aspiration was found to be superior to incision and drainage in terms of the post-procedure pain score for the patients. It is suggested that needle aspiration can be performed as the first-line treatment of peritonsillar abscess.