Tobias Gómez Susanna, Palomar Asenjo Víctor, Borràs Perera Montserrat, Pérez Hernández Isabel, Ruiz Giner Antonio, Palomar García Víctor
Servicio de Otorrinolaringología, Hospital Universitari Arnau de Vilanova, Lleida, España.
Acta Otorrinolaringol Esp. 2009 May-Jun;60(3):194-8.
Asymptomatic unilateral tonsillar enlargement is usually treated with systematic tonsillectomy under suspicion of malignancy. Due to the fact that most of the cases are benign pathologies, we set out to study the clinical signs that would help us in the diagnosis in order to avoid unnecessary tonsillectomies.
We reviewed 267 tonsillectomies performed from 1996 to 2006 and 30 of these were indicated because of asymmetry. We evaluated risk factors for malignancy: cervical lymphatic node enlargement, sex, age, tonsillar enlargement noticed by the patient, suspicious appearance, systemic symptoms, history of malignancy and immunocompromise.
Histopathologic study revealed 80 % to be benign and 20 % malignant. The risk factors with the strongest association were enlargement of cervical lymphatic nodes and suspicious appearance of the tonsil.
Strict control of a unilateral tonsillar enlargement is possible, but it is mandatory to perform a tonsillectomy when the appearance of the tonsil raises suspicions or there are enlarged lymphatic nodes.
无症状性单侧扁桃体肿大通常在怀疑恶性肿瘤时进行系统性扁桃体切除术。由于大多数病例为良性病变，我们着手研究有助于诊断的临床体征，以避免不必要的扁桃体切除术。
我们回顾了1996年至2006年期间进行的267例扁桃体切除术，其中30例因不对称而进行手术。我们评估了恶性肿瘤的危险因素：颈部淋巴结肿大、性别、年龄、患者注意到的扁桃体肿大、可疑外观、全身症状、恶性肿瘤病史和免疫功能低下。
组织病理学研究显示80%为良性，20%为恶性。关联最强的危险因素是颈部淋巴结肿大和扁桃体可疑外观。
对单侧扁桃体肿大进行严格控制是可能的，但当扁桃体外观引起怀疑或有淋巴结肿大时，必须进行扁桃体切除术。
