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Improving the management of suspected tonsillitis and peritonsillar abscess referred to ENT – a coronavirus disease 2019 service improvement

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  29 April 2021

N Cereceda-Monteoliva ,
Y Devabalan ,
H Lorenz ,
J C Magill ,
S Unadkat  and
C Rennie
N Cereceda-Monteoliva*
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
Y Devabalan
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
H Lorenz
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
J C Magill
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
S Unadkat
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
C Rennie
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
*
Author for correspondence: Mr Nicholas Cereceda-Monteoliva, Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, Hammersmith, LondonW6 8RF, UK E-mail: nicholas.cm@nhs.net
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Abstract

Background

The impact of coronavirus disease 2019 on healthcare has led to rapid changes in otolaryngology service provisions. As such, new standard operating procedures for the management of suspected tonsillitis or quinsy were implemented in our centre.

Methods

A retrospective audit was performed of acute referrals to ENT of patients with suspected tonsillitis, peritonsillar cellulitis or quinsy, during the 10 weeks before (group 1) and 10 weeks after (group 2) implementation of the new standard operating procedures.

Results

Group 2 received fewer referrals. Fewer nasendoscopies were performed and corticosteroid use was reduced. The frequency of quinsy drainage performed under local anaesthetic increased, although the difference was not statistically significant. Hospital admission rates decreased from 56.1 to 20.4 per cent, and mean length of stay increased from 1.13 to 1.5 days. Face-to-face follow up decreased from 15.0 to 8.2 per cent, whilst virtual follow up increased from 4.7 to 16.3 per cent. There were no significant differences in re-presentation or re-admission rates.

Conclusion

Management of suspected tonsillitis or quinsy using the new standard operating procedures appears to be safe and effective. This management should now be applied to an out-patient setting in otherwise systemically well patients.

Keywords

TonsillitisPeritonsillar AbscessCoronavirusPandemicsOtolaryngologyQuality Improvement
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 7 , July 2021 , pp. 584 - 588
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr N Cereceda-Monteoliva takes responsibility for the integrity of the content of the paper

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