From the Guidelines
The use of steroids in the management of ENT abscesses is generally not recommended due to the potential for worsening infection. However, in cases of significant airway compromise or severe inflammation, a short course of corticosteroids such as dexamethasone (4-8 mg IV every 8 hours) or prednisone (40-60 mg orally daily) for 24-48 hours may be considered 1.
Key Considerations
- The primary treatment for ENT abscesses remains incision and drainage, with antibiotics directed against common pathogens.
- Topical intranasal steroids may have a role in managing viral rhinosinusitis, even though they do not have a Food and Drug Administration (FDA) indication for this purpose 1.
- Oral corticosteroids may be useful for pain relief in severe disease, but their use should be cautious and limited to specific cases 1.
- The use of antibiotics should be reserved for severe symptoms or cases where watchful waiting is not appropriate, and the choice of antibiotic should be guided by evidence-based recommendations 1.
Treatment Approach
- Watchful waiting and symptomatic relief are generally recommended initially for cases not meeting the criteria for antibiotic intervention 1.
- Nasal saline irrigation and other supportive therapies may be used to relieve symptoms and promote recovery 1.
- The decision to use steroids or antibiotics should be based on a careful assessment of the patient's condition and the potential benefits and risks of treatment, with consideration of the latest evidence-based guidelines 1.
From the Research
Role of Steroid Use in ENT Abscess Treatment
The use of steroids in the treatment of abscesses in Ear, Nose, and Throat (ENT) has been studied in various research papers.
- The studies suggest that steroid use can be beneficial in reducing pain and improving clinical outcomes in patients with peritonsillar abscess 2, 3, 4.
- A systematic review of randomized controlled trials found that adjuvant corticosteroids improved clinical outcomes, including body temperature, pain scores, and duration of hospitalization, in patients with peritonsillar abscess 3.
- Another study found that a single high-dose steroid treatment was effective in relieving symptoms such as fever, throat pain, and trismus in patients with peritonsillar abscess 4.
- However, the use of steroids in the treatment of other types of ENT abscesses, such as retropharyngeal and parapharyngeal abscesses, is not well established 5.
- A service improvement study found that reducing corticosteroid use in patients with suspected tonsillitis or quinsy did not have a significant impact on patient outcomes, suggesting that steroid use may not be necessary in all cases 6.
Key Findings
- Steroid use can reduce pain and improve clinical outcomes in patients with peritonsillar abscess 2, 3, 4.
- Adjuvant corticosteroids may improve body temperature, pain scores, and duration of hospitalization in patients with peritonsillar abscess 3.
- A single high-dose steroid treatment can be effective in relieving symptoms in patients with peritonsillar abscess 4.
- The use of steroids in other types of ENT abscesses is not well established 5.
- Reducing corticosteroid use in patients with suspected tonsillitis or quinsy may not have a significant impact on patient outcomes 6.