Letters to the Editor

Figure Is Inaccurate Depiction of Procedure

Am Fam Physician. 2002 Oct 1;66(7):1155.

to the editor: In the article entitled, “Peritonsillar Abscess: Diagnosis and Treatment,”1 the illustration of needle aspiration in Figure 3 is misleading. Figure 3 shows the needle penetrating the tissue of the palatine tonsil in an attempt to drain an abscess. For several reasons, this method is not recommended by otolaryngologists. First, tonsils tend to bleed significantly if traumatized. Second, the easiest place to aspirate an abscess is in the superior peritonsillar bulge that universally accompanies this entity. This bulge is not depicted in Figure 3. Based on Figure 3 alone, one might assume that there is no abscess but rather unilateral tonsillar hypertrophy. Third, the angle of the needle as depicted increases the risk of carotid artery injury. The appropriate aspiration occurs in the palatoglossal arch without aiming the needle laterally if it can be avoided.

REFERENCE

1. Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002;65:93–6.

editor's note: Dr. Thrasher's comments are correct. The published figure does not accurately depict a peritonsillar abscess, nor does it show correct needle placement and angulation for safe drainage of an abscess. Figures 2 and 3 have been removed from the online version of the article.

 

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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