Kayabasi Serkan, Hizli Omer, Cayir Serkan, Ordu Melike
Otolaryngology, Faculty of Medicine, Aksaray University, Aksaray, TUR.
Otolaryngology, Prof. Dr. A. Ilhan Ozdemir Education and Research Hospital, Giresun University, Giresun, TUR.
Cureus. 2020 Jan 14;12(1):e6655. doi: 10.7759/cureus.6655.
Objective This study aims to review the histopathologic results of tonsillectomy specimens, determine the rates of the tonsillectomy indications, and investigate the characteristics of asymmetric hypertrophy. Materials and Methods Medical records of 484 patients who underwent tonsillectomy were reviewed retrospectively. Descriptive data of adult and pediatric patients were presented as percentage. Comparisons between asymmetric and symmetric hypertrophy groups were performed to determine the features of asymmetric hypertrophy. Results The mean age of 484 patients who underwent tonsillectomy was 13 years (range: 3-69 years). While 372 (76.85%) patients were operated for infection, 100 (20.66%) were operated for tonsillar hypertrophy, 1 (0.21%) for a suspicion of malignancy, and 11 (2.27%) for other various reasons. Asymmetric hypertrophy was seen in 25 (5.16%) patients, whereas symmetric hypertrophy was seen in 75 (15.49%) patients. Malignancy was detected in three (0.61%) adult patients with asymmetric hypertrophy. Tonsillar tuberculosis was observed in one foreign patient with asymmetric hypertrophy. The presence of malignancy was higher in the asymmetric hypertrophy group (three patients [12%]) compared with the symmetric hypertrophy group (none) (p=0.002; X=9.27). Median maximum specimen diameter was 3 cm (range: 1.15-5.5 cm) in the asymmetric hypertrophy group and 2.4 cm (range: 1.25-4.8 cm) in the symmetric hypertrophy group (p=0.08). The Friedman grade was significantly (p<0.001), positively, and strongly (r=0.885) correlated with the maximum specimen diameter. Conclusion Routine histopathologic examination of the tonsillectomy specimens might not be necessary for all patients, but it is recommended for the patients with a real asymmetry.
目的 本研究旨在回顾扁桃体切除标本的组织病理学结果,确定扁桃体切除的指征率,并调查不对称肥大的特征。材料与方法 回顾性分析484例行扁桃体切除术患者的病历。成人和儿童患者的描述性数据以百分比表示。对不对称肥大组和对称肥大组进行比较,以确定不对称肥大的特征。结果 484例行扁桃体切除术患者的平均年龄为13岁(范围:3 - 69岁)。其中,372例(76.85%)患者因感染接受手术,100例(20.66%)因扁桃体肥大接受手术,1例(0.21%)因怀疑恶性肿瘤接受手术,11例(2.27%)因其他各种原因接受手术。25例(5.16%)患者出现不对称肥大,而75例(15.49%)患者出现对称肥大。在3例(0.61%)不对称肥大的成年患者中检测到恶性肿瘤。在1例不对称肥大的外国患者中观察到扁桃体结核。与对称肥大组(无)相比,不对称肥大组中恶性肿瘤的发生率更高(3例患者[12%])(p = 0.002;X = 9.27)。不对称肥大组标本最大直径中位数为3 cm(范围:1.15 - 5.5 cm),对称肥大组为2.4 cm(范围:1.25 - 4.8 cm)(p = 0.08)。Friedman分级与标本最大直径显著正相关(p < 0.001)且相关性强(r = 0.885)。结论 并非所有患者都需要对扁桃体切除标本进行常规组织病理学检查,但建议对真正不对称的患者进行检查。