{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:32:09Z","timestamp":1792794729772,"version":"4.5.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DC005356"],"award-info":[{"award-number":["T32 DC005356"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>An uncommon phenomenon in relation to the peritonsillar abscess (PTA) is the intratonsillar abscess (ITA) or formation of an abscess within tonsillar parenchyma. This study sought to characterize our experience with diagnosis and management of ITAs in the context of the PTA patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case\u2010control series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010institution retrospective review of patients treated at the University of Michigan between 2000 and 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six hundred fifty\u2010five adult patients were identified. The incidence of ITA within the PTA population was 7% (n\u2009=\u200943). Patients with ITA had lower mean white blood cell count (<jats:italic>P<\/jats:italic>\u2009=\u2009.03), lower proportion of trismus (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001), otalgia (<jats:italic>P<\/jats:italic>\u2009=\u2009.007), vocal changes (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001), and fewer incidences of acute progression of symptoms (<jats:italic>P<\/jats:italic>\u2009=\u2009.0007). On multivariable analysis, ITA patients were noted to be older, present with a longer duration of symptoms, and have greater incidence of neck pain and lymphadenopathy. Drainage was attempted in fewer ITA patients and was rarely successful (15%) in comparison to successful drainage for PTA patients (69%) (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Symptomatology differs for ITA, as fewer present with the classic PTA symptoms of otalgia, trismus, and voice alterations. The lack of classic symptoms likely leads to delayed presentation. A greater number of ITA patients presented with neck pain and lymphadenopathy. In the ITA population, aspiration attempts were more infrequent and less successful in yielding purulence. Given infrequent yield of pus and low overall recurrence rate, the diagnosing clinician should consider medical management in this distinct patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:1354\u20131359, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27615","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T07:19:48Z","timestamp":1545290388000},"page":"1354-1359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Predictors of intratonsillar versus peritonsillar abscess: A case\u2010control series"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7922-4426","authenticated-orcid":false,"given":"S. Ahmed","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Kovatch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-7589","authenticated-orcid":false,"given":"Josh","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L.","family":"Bellile","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Hanks","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl M.","family":"Truesdale","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Hoff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine  Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2012.684399"},{"key":"e_1_2_6_3_1","first-page":"CD006287","article-title":"Needle aspiration versus incision and drainage for the treatment of peritonsillar abscess","volume":"12","author":"Chang BA","year":"2016","journal-title":"Cochrane Database Syst 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