A patient with peritonsillar abscess (PTA) presents with unilateral throat pain, dysphagia, trismus, and deviation of the uvula toward the OPPOSITE side. Which of the following explains why the uvula deviates away from the abscess side?

• A Palatal edema on the abscess side pushes the uvula toward the contralateral side
• B Spasm of the superior constrictor on the normal side pulls the uvula away from the abscess
• C Unilateral vagus nerve palsy on the abscess side causes uvular deviation to the normal side
• D The abscess collects in the superior pole causing fullness and lateral displacement of the tonsil and anterior pillar, which pushes the soft palate and uvula medially and then toward the opposite side ✓

Explanation

In peritonsillar abscess, pus accumulates in the space between the tonsil capsule and the superior constrictor muscle, predominantly at the superior pole. This causes fullness and medialization of the affected tonsil and anterior pillar. The bulging soft palate and displaced anterior pillar push the uvula across the midline toward the contralateral (non-abscess) side. The trismus results from medial pterygoid muscle irritation from the adjacent parapharyngeal space. This displacement pattern helps confirm the diagnosis clinically.

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.