Pathologic analysis of routine tonsillectomy and adenoidectomy specimens.

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.

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.