Dost P
Abteilung für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Marienhospital Gelsenkirchen, Medizinische Fakultät der Universität Duisburg-Essen, 45886, Gelsenkirchen.
HNO. 2007 Feb;55(2):100-3. doi: 10.1007/s00106-006-1431-6.
It is more and more doubted that adenoids or tonsils have to be examined histologically in pediatric cases, in which history and clinical signs and symptoms are conclusive for chronic inflammation or hyperplasia. It is unknown whether there is any conformity about this question in Germany.
The heads of all clinical departments of otorhinolaryngology (n=149) and a similar number of ENT specialists from the Berufsverband Deutscher HNO-Arzte (n=150) were surveyed by a simple questionnaire. They were asked if they would routinely send resected tissue for histopathological examination in the case of a child, up to 10 years old, presenting with a history and a status of chronic inflammation or hyperplasia and undergoing adenoidectomy or tonsillectomy. Furthermore they were asked whether they remembered any unusual or surprising report in this group of patients.
Feedback was 79%. All tissue was sent for examination by 59% of the colleagues answering this evaluation; palatine tonsils only were sent for examination by 14%, and 27% of the physicians did not send any tissue for histological work-up. During their professional career 17% of the responding ENT specialists had received a surprising result from the histopathological examination.
We do not have any consensus practiced in Germany concerning the necessity to send tissue for histopathological examination following adenoidectomy or tonsillectomy in children. It seems helpful to seek such consensus of opinion for medicolegal and socioeconomic reasons.
在儿科病例中,对于病史、临床体征和症状足以确诊为慢性炎症或增生的情况,腺样体或扁桃体是否必须进行组织学检查越来越受到质疑。在德国,对于这个问题是否存在共识尚不清楚。
通过一份简单问卷对所有耳鼻喉科临床科室主任(n = 149)以及德国耳鼻喉科医生职业协会数量相近的耳鼻喉科专家(n = 150)进行了调查。询问他们对于一名10岁以下、有慢性炎症或增生病史及现状且接受腺样体切除术或扁桃体切除术的儿童,是否会常规将切除组织送去做组织病理学检查。此外,还询问他们是否记得在这类患者中有任何不寻常或令人惊讶的报告。
反馈率为79%。在回答此次评估的同事中,59%的人将所有组织送去检查;仅将腭扁桃体送去检查的占14%,27%的医生未送任何组织进行组织学检查。在其职业生涯中,17%的受访耳鼻喉科专家从组织病理学检查中得到过令人惊讶的结果。
在德国,对于儿童腺样体切除术或扁桃体切除术后是否有必要将组织送去做组织病理学检查,我们没有达成任何共识。出于法医学和社会经济学原因,寻求这样的共识意见似乎是有益的。