Are Histologic Studies of Adenotonsillectomy Really Necessary?

Rebechi, Giseli; Pontes, Thiago Euênio; Braga, Elias Lobo; Matos, Willian Maduel; Rebechi, Fernando; Matsuyama, Cícero

doi:10.1055/s-0033-1353441

Cited by 5 publications

(5 citation statements)

References 12 publications

(12 reference statements)

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“…They found evidence of chronic tonsillitis with colonies of actinomyces in 9.6% of their patients. 18 In light of our findings, we concur with Hasan et al, who suggested that actinomycosis is likely to have a causal association with recurrent tonsillitis and tonsillar hypertrophy. 17…”

Section: Discussionsupporting

confidence: 92%

Tonsil histopathology in HIV-infected versus HIV-uninfected adults

Essa

Maharaj

Hari

et al. 2019

Southern African Journal of HIV Medicine

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Background The relationship between HIV and tonsil malignancy has not been fully investigated and established. Both of these diseases prominently feature in the Otorhinolaryngology clinics. Objective There is minimal data available on the histopathology of tonsillectomy specimens in the HIV-infected population. This retrospective review compared tonsil histopathology between HIV-infected and HIV-uninfected patients. Methods Of the 319 adult patients undergoing tonsillectomy (01 July 2005 to 30 June 2015), HIV results were available for 160. The histological findings were compared in the HIV-infected and HIV-uninfected subgroups. The effects of age, HIV status and CD4 count on the risk of malignancy were determined. Results There were 86 patients who were HIV-infected and 74 were uninfected. Reactive lymphoid hyperplasia was the most common diagnosis in both groups (77%). Malignancies were diagnosed in eight HIV-infected and six HIV-uninfected patients, an insignificant difference. Conclusion The majority of patients undergoing tonsillectomy had benign conditions. HIV status does not appear to be a specific risk factor for tonsil malignancies, but advanced age may be.

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Section: Discussionsupporting

confidence: 92%

Tonsil histopathology in HIV-infected versus HIV-uninfected adults

Essa

Maharaj

Hari

et al. 2019

Southern African Journal of HIV Medicine

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“…All the patients were discharged to ear, nose, and throat outpatient clinic between the 1 st and 3 rd postoperative days depending on the patients response to postoperative care. All the adenoid and tonsils specimens' tissue histological examination reported reactive lymphoid hyperplasia in this study as observed in previous studies 111213141521…”

Section: Discussionsupporting

confidence: 87%

“…There is controversy on the mandatory adenotonsillar tissue specimen histologic evaluation in children. Adenoidectomy and tonsillectomy are performed secondary to inflammation/infection in children, not malignancy as in some adult cases 1112. This is assumed to be a waste of money in low-income resource countries like ours.…”

Section: Introductionmentioning

confidence: 97%

Outcome of adenotonsillar specimen histology in a private hospital setting

Adegbiji

Aremu

Oladipo³

2019

Niger Med J

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Background:All adenoid and tonsils tissue specimens are routinely histologically examined in pediatric otorhinolaryngology practice worldwide. This study aimed at determining the sociodemographic features, clinical presentation, indications, postoperative management, and histological diagnosis of the adenoid and tonsils tissues.Materials and Methods:This is a retrospective hospital-based study of patients who had adenotonsillectomy done between August 2008 and July 2018 at Golden Cross Infirmary Hospital, Festac Town, Lagos, Nigeria. All data were obtained from the patients' record, case note, and theater operation register. All the data obtained were collated and analyzed using SPSS version 18.0.Results:There were 59.2% of males with a male-to-female ratio of 1.5:1. Clinical presentation among the pediatric patients was 71.8% difficulty breathing, 64.8% snoring, 63.4% sleep apnea, 60.6% catarrh, and 54.9% noisy breathing. The most common indications for adenoid and tonsils surgery were obstructive sleep apnea in 64.8%. Adenoidectomy in 42.3% was the most common form of pediatric adenoid and tonsils surgery. The most common complication of adenoid and tonsils surgery was pain at surgical site/odynophagia in all the patients. Postoperative histological reports were reactive lymphoid hyperplasia in all the patients.Conclusion:Adenoid and tonsils surgeries are common pediatric otorhinolaryngology, head-and-neck surgical procedures. The most common indication found for adenoid and tonsils surgery was obstructive sleep. Adenoidectomy was the most common form of pediatric adenoid and tonsils surgery. All the adenoid and tonsils tissue specimens revealed histological benign diseases.

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“…Our study showed a zero prevalence of malignancy in tissue extracted from adeno-tonsillectomy in children. This is akin to the studies of Giseli et al [6] and Vema et al [7] who obtained zero prevalence of malignant adenoid tissue and questioned the need for histology after adenoid and tonsillar surgery in children. Other literature though refuted our findings but yet show a very low prevalence of malignancy in adeno-tonsillar tissue.…”

Section: Discussionmentioning

confidence: 79%

“…Most otolaryngology services usually send tissue specimen from adenoids, tonsils or both for histopathologic examination. This they do mainly to rule out malignancy or as a routine investigation or even for medico-legal reasons [6]. Previous studies have shown that routine histopathologic analysis of the tonsil is unnecessary, because this histology review normally show extremely low prevalence of malignant changes [7].…”

Section: Discussionmentioning

confidence: 99%

What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

Chinawa

Akpe

et al. 2019

Pan Afr Med J

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Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histologyThe objective of this study was to determine the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, 1 adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper airway obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio.

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Are Histologic Studies of Adenotonsillectomy Really Necessary?

Cited by 5 publications

References 12 publications

Tonsil histopathology in HIV-infected versus HIV-uninfected adults

Tonsil histopathology in HIV-infected versus HIV-uninfected adults

Outcome of adenotonsillar specimen histology in a private hospital setting

What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

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