Department of Otolaryngology and Laryngological Oncology with the Clinical Department of Cartilage-Maxillofacial Surgery, Central Clinical Hospital of the Ministry of National Defense, Military Medical Institute.
Department of Pathomorphology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine.
Otolaryngol Pol. 2020 Jun 1;74(5):1-5. doi: 10.5604/01.3001.0014.1612.
<b>Introduction:</b> Tonsillectomy belongs to the most frequently performed surgical treatments; however, the necessity of its performance is questioned. Therefore, there are many attempts to unify and define the indications for the procedure. <br><b>Aim:</b> The main objective of the current dissertation was an analysis of the clinical symptoms occurring in patients qualified for tonsillectomy, as well as a comparison of those with a histopathological image of the removed tonsils in a repeatedly carried out, unified pathomorphological examination. The secondary objective was the designation of the demographic profile, existing comorbidities, and complications in the form of postoperative bleeding in patients after tonsillectomy in own material. <br><b>Material and method:</b> A retrospective analysis of 301 procedures of palatine tonsil removal was performed, which were completed in the years 2017-2019 at the Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery of the Military Institute of Medicine, Warsaw, Poland. The indications were defined on the grounds of data from the anamnesis. Based on unified criteria, the removed material was divided into 2 groups: with the signs of Chronic Tonsillitis (CT) as well as Tonsillar Hyperthrophy (TH). <br><b>Results:</b> The average size of tonsils was the greatest in a group of patients under 35 years of age, and smallest in the group over 51 years of age. As patients aged, the reduction in size of the palatal tonsils was observed. In the examined group, the histopathological diagnosis in the form of HT was found in 165 patients (54.8%), while CT in 136 (45.2%). It was proven that the larger the tonsils in the clinical picture, the more often the histopathological image responded to HT. Among clinical symptoms reported by patients qualified for tonsillectomy, the following were observed: recurring tonsil inflammation in 211 (70.1%), snoring and sleep apnea in 47 (15.6%), as well as sleep apnea in 33 (11%) patients. Primary bleeding occurred in 10 patients (3.34%), and secondary in 8 patients (2.66%). The most common comorbidities were cardiovascular burdens. <br><b>Conclusions:</b> For most cases, clinical symptoms were confirmed by adequate features of removed material in histopathological examination. The most common histopathological diagnosis was tonsillar hyperthrophy.
<b>引言:</b>扁桃体切除术属于最常进行的手术治疗之一;然而,其手术的必要性受到质疑。因此,人们一直在努力统一并定义该手术的适应证。<br><b>目的:</b>本论文的主要目的是分析符合扁桃体切除术适应证的患者的临床症状,并在反复进行的统一病理形态学检查中比较这些患者的临床症状与切除扁桃体的组织病理学图像。次要目的是指定在波兰华沙军事医学研究所耳鼻咽喉科-颅面外科部进行的 2017 年至 2019 年期间的 301 例腭扁桃体切除术患者的人口统计学特征、并存疾病和术后出血等并发症。<br><b>材料与方法:</b>对波兰华沙军事医学研究所耳鼻咽喉科-颅面外科部进行的 301 例腭扁桃体切除术的回顾性分析,适应证根据病史资料确定。根据统一标准,切除的标本分为 2 组:有慢性扁桃体炎(CT)和扁桃体肥大(TH)征象的组。<br><b>结果:</b>在 35 岁以下的患者中,扁桃体的平均大小最大,而在 51 岁以上的患者中,扁桃体的平均大小最小。随着患者年龄的增长,腭扁桃体的大小逐渐减小。在检查的患者中,165 例(54.8%)的组织病理学诊断为 HT,136 例(45.2%)的组织病理学诊断为 CT。研究结果表明,临床症状中扁桃体越大,组织病理学图像越倾向于 HT。在符合扁桃体切除术适应证的患者中报告的临床症状包括:211 例(70.1%)反复发作的扁桃体炎、47 例(15.6%)打鼾和睡眠呼吸暂停以及 33 例(11%)睡眠呼吸暂停。原发性出血发生在 10 例(3.34%)患者中,继发性出血发生在 8 例(2.66%)患者中。最常见的合并症是心血管负担。<br><b>结论:</b>对于大多数病例,临床症状在组织病理学检查中被切除标本的适当特征所证实。最常见的组织病理学诊断是扁桃体肥大。