Evaluation of the utility and cost-effectiveness of obtaining histopathologic diagnosis on all routine tonsillectomy specimens

Ramzi T. Younis, Sabine V. Hesse, Vinod K. Anand

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Objectives: To evaluate the use and necessity of obtaining histopathology on patients undergoing tonsillectomy, and to provide indications and guidelines for requesting histopathology on tonsillectomy patients. Study Design: At the University of Mississippi Medical Center, we have been routinely obtaining histopathologic diagnoses on every patient undergoing tonsillectomy or tonsillectomy and adenoidectomy. Specimens are separated into left and right tonsils and adenoids. This study was designed at our tertiary care academic center to evaluate the necessity for obtaining histopathologic diagnosis on each of these patients. Methods: A retrospective review of histopathologic reports on all patients in both pediatric and adult age groups undergoing tonsillectomy or tonsillectomy and adenoidectomy between January 1994 and December 1999 was performed. Results: A total of 2438 reports were reviewed. There were 2099 in the pediatric age group and 339 were adults. None of the children had an unusual histopathology finding other than lymphoid hyperplasia. Of the 339 adults, 34 had squamous cell carcinoma and 6 had lymphoma; however, these findings were suspected preoperatively by history and clinical manifestations. Conclusions: The general practice guidelines mandate obtaining histopathologic diagnoses on most of the tissues received. Based on our review, histopathology of tonsillectomy and/or adenoidectomy may not be necessary, especially in children. In this era of cutting excess costs of health care dollars, waving histopathology in these cases may have major implications without compromising delivery of quality care.

Original languageEnglish (US)
Pages (from-to)2166-2169
Number of pages4
JournalLaryngoscope
Volume111
Issue number12
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Histopathology
  • Lymphoid hyperplasia
  • Tonsil malignancy
  • Tonsillectomy

ASJC Scopus subject areas

  • Otorhinolaryngology

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