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Year: 2013  Vol. 17   Num. 4  - Oct/Dec
DOI: 10.1055/s-0033-1353441
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Original Article
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Are Histologic Studies of Adenotonsillectomy Really Necessary?
Estudos Histopatolgicos de Cirurgias de Adenotonsilectomias so Realmente Necessrios?
Author(s):
Giseli Rebechi, Thiago Eunio Pontes, Elias Lobo Braga, Willian Maduel Matos, Fernando Rebechi, Ccero Matsuyama
Key words:
tonsillar neoplasms - tonsillectomy - adenoidectomy
Abstract:

Introduction: In most ear, nose, and throat services, it is routine to send the material extracted from tonsillectomy for histologic study to research malignancy, to analyze suspect material, or to provide medical-legal documentation. Recent studies have shown that this routine analysis is dispensable.

Objective: To evaluate the actual need and perform a cost-benefit analysis of routine histopathologic examination in tonsillectomy with no signs or symptoms of malignancy.

Methods: A retrospective observational study evaluated the charts of patients undergoing adenotonsillectomy, tonsillectomy, or adenoidectomy from January 2008 to September 2009 at the Institute of Otorhinolaryngology CEMA-SP. Costs of this test for the public health system were analyzed and the literature reviewed.

Results: We studied 281 patients between 2 and 22 years of age; 142 (50.5%) were male and 139 (49.5%) were female. Of the surgeries, 201 were adenotonsillectomies (71.5%), 41 were tonsillectomies (14.5%), and 39 were adenoidectomies (14%). The most common indication for surgery was recurrent infection (63.3%). None of study patients had clinical suspicion of malignancy. The tests showed a cost of R$20.03 per tonsil analyzed.

Conclusion: Routine histopathologic examination in patients undergoing adenotonsillectomy with no signs or symptoms of malignancy is dispensable and increases the cost of the surgeries.

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