Citation Information :
Varute VP, Mohite AA, Mane RS, Patil BC, Tarlekar GM, Kundu D, Lakshmi J. Routine Histopathological Examination in Patients of Adenotonsillectomies: Evaluation of Its Necessity. Int J Otorhinolaryngol Clin 2022; 14 (3):82-84.
Background: Tonsillectomy and/or adenoidectomy is a common otolaryngologic surgical procedure. The histopathological examination (HPE) of excised tissue after these surgeries is controversial. The study aimed to evaluate the necessity of histopathological analysis of excised tonsils.
Materials and methods: The prospective study was performed between January 2017 and December 2018 on HPE results of 200 patients including children and adults, who had adenotonsillectomy in the Department of ENT at the tertiary care center, Kolhapur.
Results: A total of 400 HPE results from 200 patients (150 children, 50 adults) were included in the study. HPE of all the excised samples was detected with submucosal hyperplastic lymphoid follicles, reactive germinal centers, and bacterial colonies in crypts. No malignancy was detected.
Conclusion: Histopathological evaluation of excised tonsils is not necessary in the absence of associated risk factors.
Clinical significance: The incidence of malignancy in excised tonsils or adenoids is very rare; therefore, routine histopathological examination is not necessary except in patients with associated risk factors. This will help reduce unnecessary costings and labor.
Aksakal C, Müslehiddinoğlu A. Comparison of routine histopathological exaxmination results in children and adults after tonsillectomy and/or adenoidectomy. Turk Arch Otorhinolaryngol 2018;56(3):170. DOI: 10.5152/tao.2018.3391.
Smith MM, Peterson E, Yaremchuk KL. The role of tonsillectomy in adults with tonsillar hypertrophy and obstructive sleep apnea. Otolaryngol Head Neck Surg 2017;157(2):331. DOI: 10.1177/0194599817698671.
Papouliakos S, Karkos PD, Korres G, et al. Comparison of clinical and histopathological evaluation of tonsils in pediatric and adult patients. Eur Arch Otorhinolaryngol 2009;266(8):1309. DOI: 10.1007/s00405-008-0869-4.
Randall DA, Martin PJ, Thompson LDR. Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy. Laryngoscope 2007;117(9):1600. DOI: 10.1097/MLG.0b013e318093ee4e.
Booth CL, Wang J. Occult hematologic malignancy in routine tonsillectomy specimens: a single institutional experience and review of the literature. Am J Clin Pathol 2013;140(6):807. DOI: 10.1309/AJCPCM7LN4QEZPOQ.
Younis RT, Hesse SV, Anand VK. Evaluation of the utility and cost-effectiveness of obtaining histopathologic diagnosis on all routine tonsillectomy specimens. Laryngoscope 2001;111(12):2166. DOI: 10.1097/00005537-200112000-00017.
Maharjan S, Neopane P, Parajuli R. Histopathological examination of routine tonsil or adenoid specimens in a tertiary care Centre of Nepal: evaluation of its necessity and cost-benefit rate analysis. Global J Laryngol 2017;8(2):55573. DOI: 10.19080/GJO.2017.08.555733.
Felix F, Gomes GA, de Souza BP, et al. Evaluation of the utility of histopathologic exam as a routine in Tonsillectomies. Rev Bras Otorhinolaryngol 2006;72(2):252. DOI: 10.1016/S1808-8694 (15)30064-1.
Strong EB, Rubinstein B, Senders CW. Pathologic analysis of routine tonsillectomy and adenoidectomy specimens. Otolaryngol Head Neck Surg 2001;125(5):473. DOI: 10.1067/mhn.2001.119862.
Beaty MM, Funk GF, Karnell LH, et al. Risk factors for malignancy in adult tonsils. Head Neck 1998;20(5):399. DOI: 10.1002/(sici)1097-0347(199808)20:5<399::aid-hed7>3.0.co;2-t.
Pransky SM, Feldman JI, Kearns DB, et al. Actinomycosis in obstructive tonsillar hypertrophy and recurrent tonsillitis. Arch Otolaryngol Head Neck Surg 1991;117(8):883. DOI: 10.1001/archotol. 1991.01870200077012.
Toh ST, Yuen HW, Goh YH. Actinomyces colonization of tonsils: a comparative study between patients with and without recurrent tonsillitis. J Laryngol Otol 2007;121(8):775. DOI: 10.1017/S00222151060 03185.
Ozgursoy OB, Kemal O, Saatci MR, et al. Actinomyces in the etiology of recurrent tonsillitis and obstructive tonsillar hypertrophy: answer from a histopathologic point of view. J Otolaryngol Head Neck Surg DOI: 2008;37(6):865. PMID: 19128718.
Kepekçi AH, Balıkci HH. Is routine histopathologic examination necessary following tonsillectomy and/or adenoidectomy procedures in pediatric patients? J Craniofac Surg 2017;28(1):e91. DOI: 10.1097/SCS.0000000000003278.
Kalcioglu MT, Gurses I, Erdem T. Is the pathological examination of routine tonsillectomy and adenoidectomy specimens necessary? A retrospective study of 559 adenoidectomy and 1,132 tonsillectomy specimens and a literature review. DOI: B-ENT 2010;6(2):91. PMID: 20681360.