Comparing Transoral Ultrasound With Standard Clinical Examination to Diagnose Peritonsillar Abscess in Adults

What this Trial Is About

Researchers are evaluating whether using transoral ultrasound improves the diagnostic accuracy for patients suspected of having a peritonsillar abscess PTA. PTA is a collection of pus near the tonsil causing pain and swelling, and it can be difficult to distinguish from peritonsillar cellulitis or tonsillitis by clinical examination alone. This multicenter cluster randomized trial compares traditional clinical examination with and without transoral ultrasound to see which method better identifies PTA and reduces unnecessary procedures. The study involves two groups one receiving clinical examination combined with transoral ultrasound performed by a head and neck surgeon using a small hockey stick ultrasound probe placed inside the mouth, and the other receiving only the standard clinical examination including visual inspection and fiberoptic laryngoscopy. If PTA is suspected, needle aspiration to drain pus is performed, guided by ultrasound in the intervention group. Patients are randomized weekly by clinic visit week to either group. The trial runs from June 2025 to June 2026 at multiple hospitals. Participants are patients 18 years or older referred to outpatient ENT clinics with suspected PTA. During their first visit, clinical data, examination findings, and treatment details are recorded. Follow-up includes tracking diagnostic accuracy, number of surgical procedures, needle aspirations, hospital visits, and admissions over up to two months. The study monitors whether ultrasound use leads to fewer missed abscesses and fewer unnecessary aspirations, aiming to improve standard diagnostic care for PTA.

Transoral Ultrasound Versus no Transoral Ultrasound in Diagnostic Workup of Peritonsillar Abscess