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Am Fam Physician. 2002;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.

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.

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