A 30-year-old presents with severe right-sided sore throat, trismus, muffled ('hot potato') voice, uvular deviation to the LEFT, and bulging of the RIGHT peritonsillar area. Where is the abscess pointing, and what is the preferred drainage site?
- A Abscess is on the LEFT; drainage at the point of maximum fluctuance on the left
- B Abscess is bilateral; bilateral incision and drainage required
- C Abscess is on the RIGHT (uvula deviates away from the abscess); drainage at the junction of the posterior pillar and soft palate on the right, or at maximum fluctuance ✓
- D Abscess is retropharyngeal; drainage via external neck approach
Correct answer: C. Abscess is on the RIGHT (uvula deviates away from the abscess); drainage at the junction of the posterior pillar and soft palate on the right, or at maximum fluctuance
Explanation
In peritonsillar abscess (quinsy), the uvula and soft palate are displaced AWAY from the side of the abscess. Therefore, leftward uvular deviation indicates a right-sided peritonsillar abscess. Drainage is performed by incision at the point of maximum fluctuance — classically at the superior pole of the tonsillar fossa (junction of anterior pillar and soft palate) under local anesthesia. Interval tonsillectomy may be performed to prevent recurrence.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.