Wednesday, February 3, 2016

ENT Procedure 5 drain pertonsil abcess

Drain Peritonsillar Abscess or Quinsy
Objective
To drain an abscess between the surgical capsule of the tonsil and the superior constrictor muscle and fascia of the adjacent lateral pharyngeal wall.
Position
Sitting, facing the surgeon, or lateral position with the table in slight Trendelenburg.
Anesthesia

Local: 2 cc Lignocaine in the palatal mucosa.
Procedure

1.  Open mouth.

2.  Guide with finger of left hand Parkar knife size 15 to the fluctuant part of visible abscess.

3.  Press point of knife backwards through mucosa into abscess.

4.  Pus gushes out.

5.  Swab and Suck out pus.

6.  Guide sinus forceps into opening.

Instruments

•   Scalpel handle No. 3 with No. 15 blade wrapped with adhesive plaster, tip only exposed

•   Sponge-holding forceps (Rampley) and small sponges or swabs, 5

•   Mouth gag (Mason or Doyen) (Figs 16.15 and 16.16)

•   Angled tongue depressor (Fig. 16.31)

•   Scissors

•   Sinus forceps

•   Pharyngeal spray and 4 percent lignocaine

•   Sterile swab.
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