A Systematic Review of Peritonsillar Abscess Simulators: Enhancing Training and Identifying the Need for Standardization

Abstract

Objectives: To systematically review the literature regarding previously described peritonsillar abscess (PTA) drainage simulation.

Data sources: PubMed, Scopus, Web of Science, Ovid, and Cochrane.

Review methods: A search of the abovementioned databases was performed in August 2022 using the terms "peritonsillar abscess/quinsy," "incision/drainage/aspiration," and "simulation." No time restrictions were applied. We included studies that clearly described how their PTA models were built and underwent validation from experts and/or evaluation from trainees. Articles describing a model only without any evaluation and reports in languages other than English were excluded.

Results: Our search initially yielded 80 articles after duplicate removal, 10 of which met our criteria and were included. Two studies trained participants on both needle aspiration and incision and drainage (I&D), four studies on I&D only, and four on needle aspiration only. 87.5% to 100% of junior residents reported minimal exposure to PTA prior to simulation. Five studies provided some form of validation to their models. The value of the simulators to train participants on skills received better appreciation than their anatomical fidelity. The perceived confidence level of trainees in managing PTA, which was assessed in 7 studies, substantially improved after training.

Conclusion: PTA simulation improves the confidence of trainees to perform PTA drainage. There is, however, a lack of standardization and evidence regarding transfer validity among PTA simulators. The development of a standardized PTA simulator could allow for more widespread use and increase resident comfort with this procedure in a pre-clinical setting.

Level of evidence: NA Laryngoscope, 134:2495-2501, 2024.

Keywords: cadaver; medical education; otolaryngology; peritonsillar abscess; residency; simulation.