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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
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Malignancy in routine tonsillectomy specimens: a systematic literature review
Malene Sine Rokkjaer1, Tejs Ehlers Klug
1Department of Otorhinolaryngology, Head and Neck Surgery, Holstebro Hospital, Laegårdvej 12, 7500, Holstebro, Denmark, malrok@rm.dk.
Summary
Routine tonsillectomy rarely reveals unsuspected tonsillar malignancy (0.015%). This systematic review suggests routine histological examination may not be justified for patients without risk factors, warranting updated guidelines.
Area of Science:
- Otolaryngology
- Pathology
- Oncology
Background:
- Tonsillectomy is a common surgical procedure.
- Histological examination of tonsillectomy specimens is standard practice.
- The incidence of unsuspected malignancy in routine tonsillectomies is not well-established.
Purpose of the Study:
- To determine the prevalence of unsuspected tonsillar malignancy in routine tonsillectomy specimens.
- To evaluate the necessity of histological examination in the absence of risk factors.
Main Methods:
- Systematic literature review adhering to PRISMA 2009 guidelines.
- Inclusion of articles reporting on unsuspected tonsillar malignancy in routine tonsillectomy specimens.
- Definition of unsuspected malignancy excluding patients with specific risk factors.
Main Results:
- Analysis of 37 articles involving 72,322 patients.
- Overall prevalence of unsuspected tonsillar malignancy was 0.015% (11 cases).
- Prevalence in adults was 0.05% (3/6,434), and in children was 0.01% (3/21,223).
Conclusions:
- The extremely low prevalence of unsuspected malignancy in clinically benign tonsils does not support routine histological examination.
- Further investigation into national guidelines or ENT society statements is recommended.
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