A unifying theory of tonsillitis, intratonsillar abscess and peritonsillar abscess.

We review existing models of the pathogenesis of peritonsillar abscess (PTA) and intra-tonsillar abscess (ITA) and present a novel pathophysiologic model based upon observed histopathology in 2 ITAs and 10 PTAs and acute tonsillitis cases. ITA is rare, and prevailing models are only able to account for a minority of cases. The tonsillar lymphatic ultrastucture and the rapid nature of intratonsillar lymphatic transit, offer the framework for a unifying model of the development and progression of tonsillitis, PTA and ITA.