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Is the pathological examination of routine tonsillectomy and adenoidectomy specimens necessary? A retrospective study of 559 adenoidectomy and 1132 tonsillectomy specimens and a literature review.
Objective: There is still no consensus about the necessity of histopathological analysis of routine tonsillectomy and adenoidectomy specimens. In this study, our goal was to determine the incidence of unexpected pathological findings in routine tonsillectomy and adenoidectomy specimens. The results are discussed in the light of current literature.
Materials and methods: The patient data were obtained from the archives of the departments of otorhinolaryngology and pathology. Between November 1992 and July 2006, chronic, recurrent infections or obstructive problems led to bilateral tonsillectomies, adenoidectomies, and adenoidectomies plus tonsillectomies being performed in 435, 502, and 770 patients respectively. Five hundred and fifty-nine of 1272 adenoidectomy specimens and 1132 of 2410 tonsillectomy specimens were sent to the department of pathology for histopathological examination.
Results: The histopathological results for all the adenoidectomy specimens reported chronic inflammatory processes. Only one of 1132 tonsillectomy specimens involved granulomatous inflammation, while 1131 were chronic inflammatory processes.
Conclusion: On the basis of the result of our study and review of the published literature, the microscopic analysis of routine tonsillectomy and/or adenoidectomy specimens may not be necessary, especially in young patients with no clinically suspicious factors for malignancy. However, all patients must be carefully examined for evidence of malignancy before surgery.