Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Otolaryngol Head Neck Surg. 2020 Oct;163(4):743-749. doi: 10.1177/0194599820921392. Epub 2020 May 5.
To better characterize associations between and tonsillolith versus nontonsillolith tonsillectomy specimens.
Bi-institutional retrospective case-case study.
University and county hospital.
Adult patients with a clinical history of tonsilloliths who underwent tonsillectomy from January 2006 to December 2018 were included. Patients undergoing tonsillectomy for tonsillar hypertrophy and chronic tonsillitis were identified as comparative cases. Similarly, patients with ipsilateral oropharyngeal cancer (OPC) who underwent contralateral tonsillectomy of a normal-appearing tonsil for prophylaxis against a second primary cancer were also included as comparative cases.
The study population comprised 134 patients who underwent tonsillectomy: 62 tonsillolith and 72 nontonsillolith (tonsillar hypertrophy, n = 30; chronic tonsillitis, n = 30; normal-appearing contralateral tonsil in patients with ipsilateral OPC, n = 12). was reported in 11% of the patients with tonsilloliths on initial pathology reports but in 95% after re-evaluation (n = 54 of 57). prevalence was significantly higher in patients with tonsilloliths as compared with patients with recurrent tonsillitis (73%, n = 22 of 30, < .001) and normal-appearing contralateral tonsils in patients with ipsilateral OPC (58%, n = 7 of 12, < .001). prevalence was not significantly different between patients with tonsilloliths and tonsillar hypertrophy (83%, n = 25 of 30, = .11).
The prevalence of in tonsillolith tonsil specimens is high; however, routinely colonizes nontonsillolith tonsil specimens. Therefore, is unlikely to be the primary driver of tonsillolith pathogenesis, and targeted treatment of tonsilloliths may not be effective. Treatment strategies addressing tonsilloliths should be further investigated.
更好地描述 与扁桃体结石和非扁桃体结石性扁桃体切除术标本之间的关联。
机构间回顾性病例对照研究。
大学和县级医院。
纳入 2006 年 1 月至 2018 年 12 月期间因临床诊断为扁桃体结石而行扁桃体切除术的成年患者。将因扁桃体肥大和慢性扁桃体炎而行扁桃体切除术的患者确定为对照病例。同样，因同侧口咽癌（OPC）而行对侧正常外观扁桃体切除术以预防第二原发癌的患者也被纳入对照病例。
研究人群包括 134 例接受扁桃体切除术的患者：62 例为扁桃体结石，72 例为非扁桃体结石（扁桃体肥大，n = 30；慢性扁桃体炎，n = 30；同侧 OPC 患者对侧正常外观扁桃体，n = 12）。最初的病理报告显示 11%的扁桃体结石患者存在 ，但重新评估后这一比例上升至 95%（n = 54/57）。与复发性扁桃体炎患者（73%，n = 22/30，<.001）和同侧 OPC 患者对侧正常外观扁桃体（58%，n = 7/12，<.001）相比，扁桃体结石患者的 患病率显著更高。与扁桃体肥大患者（83%，n = 25/30，=.11）相比，扁桃体结石患者的 患病率无显著差异。
扁桃体结石标本中 的患病率较高；然而， 通常定植于非扁桃体结石性扁桃体标本。因此， 不太可能是扁桃体结石发病机制的主要驱动因素，针对扁桃体结石的靶向治疗可能无效。进一步需要研究针对扁桃体结石的治疗策略。
