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Pathologic analysis of routine tonsillectomy and adenoidectomy specimens.

E B Strong1, B Rubinstein, C W Senders

  • 1Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, School of Medicine,Sacramento 95817, USA. ebstrong@ucdavis.edu

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|November 9, 2001
PubMed
Summary

Otolaryngologists increasingly opt for reduced pathology analysis of tonsillectomy and adenoidectomy (T&A) specimens. This trend, observed between 1989 and 1999, did not correlate with practice type and found no occult malignancies in pediatric T&A samples.

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Area of Science:

  • Otolaryngology
  • Pathology
  • Surgical Specimen Handling

Background:

  • Recent literature questions the necessity of routine histopathologic analysis for tonsillectomy and adenoidectomy (T&A) specimens.
  • This study examines trends in T&A specimen handling practices in the United States from 1989 to 1999.

Purpose of the Study:

  • To investigate the changes in pathologic processing practices for T&A specimens among otolaryngologists.
  • To assess the incidence of occult malignancies in pediatric T&A specimens under evolving handling protocols.

Main Methods:

  • A survey was distributed to 4715 members of the American Academy of Otolaryngology, assessing practice type and pathology processing methods (full, gross, no pathology).
  • A retrospective analysis of 1583 pediatric T&A specimens was conducted to identify any undetected malignancies.

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Main Results:

  • Survey responses indicated a significant increase (P < 0.001) in otolaryngologists selecting "gross only" or "no pathology" for T&A specimens.
  • The retrospective analysis of pediatric T&A specimens revealed no cases of occult malignancy.
  • Practice types included private (80%), academic (12%), salaried (6%), and military (2%).

Conclusions:

  • There has been a statistically significant rise in the number of otolaryngologists utilizing "gross only" or "no pathology" examination for routine T&A specimens.
  • No association was found between practice type and the observed changes in pathologic analysis of T&A specimens.