Clinicopathologic analysis of tonsillectomy tissues in a tertiary health centre in Benin City, Nigeria
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Abstract
Background: Tonsillectomy is a common surgical procedure in otorhinolaryngology, indications for which should be met before surgery. To subject tonsillectomy tissue specimen to histologic analysis has become an issue of debate in recent times, thus necessitating a review of tonsillectomy tissues at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.
Aim: The aim of this study is to determine the indications for tonsillectomy and relevance of histologic diagnosis of tonsillectomy tissue specimen.
Methods: A 5-year retrospective study; January 2010–December 2014 of tonsillectomy tissue specimens received in the Department of Pathology of UBTH were evaluated with regard to patients’ clinical information and histologic diagnosis.
Results: A total of 224 patients with M: F ratio of 1.2:1 was reviewed. Obstructive airway disease was the most common indication for surgery; 167 (73.2%), whereas the predominant histologic diagnosis was reactive lymphoid hyperplasia; 219 (97.8%). Five (2.2%) of the tissue specimens showed features of malignancy.
Conclusion: The most common indication for tonsillectomy was obstructive airway disease. Although the majority of tissue specimens revealed benign features, the recorded number of the malignant specimen was quite considerable. Thus, there is the need to subject all tonsillectomy tissues to histologic analysis.
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References
1. Beasley N. Anatomy of the pharynx and oesophagus. In: Gleeson M, editor. Scott Brown’s Otolaryngology Head and Neck Surgery. 7th ed.,
Vol. 2. London: Arnold, 2008; 1942‑53.
2. Alfredo RD, Antonio JC, Cinthia M, Jose CN, Kazue K, Renato MP. Histological analysis of tonsillectomy and adenoidectomy specimens. Rev Bras Otorrinolaringol 2005;71:18‑22.
3. Younis RT, Hesse SV, Anand VK. Evaluation of the utility and cost‑effectiveness of obtaining histopathologic diagnosis on all routine
tonsillectomy specimens. Laryngoscope 2001;111:2166‑9.
4. Olusesi AD, Undie NB, Amodu JE. Allergy history as a predictor of early onset adenoids/adenotonsillar hypertrophy among Nigerian children. Int J Pediatr Otorhinolaryngol 2013;77:1032‑5.
5. Redline S, Tishler PV, Schluchter M, Aylor J, Clark K, Graham G, et al. Risk factors for sleep‑disordered breathing in children. Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 1999;159:1527‑32.
6. Stradling JR, Thomas G, Warley AR, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet 1990;335:249‑53.
7. Gaultier C, Guilleminault C. Genetics, control of breathing, and sleep‑disordered breathing: A review. Sleep Med 2001;2:281‑95.
8. Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J, et al. Tonsillectomy versus watchful waiting in recurrent streptococcal
pharyngitis in adults: Randomised controlled trial. BMJ 2007;334:939.
9. Karaman M, Tek A, Tuncel A, Oysu C, Sheidaei S. Adult tonsillectomy: Relationship between indications and postoperative hemorrhage. Kulak
Burun Bogaz Ihtis Derg 2012;22:21‑5.
10. Scottish Intercollegiate Guidelines Network. Management of Sore Throats and Indications for Tonsillectomy: Quick Reference Guide; 1999. Available from: http://www.sigh.ac.uk/pdf/qrg34.pdf. [Last accessed on 2017 Oct 16].
11. American Academy of Otolaryngology Head and Neck Surgery. Clinical Indicators Compendium. Alexandria, VA: American Academy of Otolaryngology Head and Neck Surgery, 2000; 19.
12. Ibekwe TS, Obasikene G, Offiong E. Tonsillectomy: Vasoconstrictive hydrolytic cold dissection method. Afr J Paediatr Surg 2013;10:150‑3.
13. AAO‑HNS Guidelines for Tonsillectomy in Children and Adolescents in American Family Physician Menu. Available from: http://www.aafp.
org/afp/2011/0901/p566.html. [Last accessed on 2017 Aug 06].
14. Felippe F, Gomes GA, de Souza BP, Cardoso GA, Tomita S. Evaluation of the utility of histopathologic exam as a routine in tonsillectomies.
Braz J Otorhinolaryngol 2006;72:252‑5.
15. Netser JC, Robinson RA, Smith RJ, Raab SS. Value‑based pathology: A cost‑benefit analysis of the examination of routine and nonroutine
tonsil and adenoid specimens. Am J Clin Pathol 1997;108:158‑65.
16. Dell’Aringa AR, Juares AJ, de Melo C, Nardi JC, Kobari K, Perches Filho RM. Hsitological analysis of tonsillectomy and adenoidectomy specimens – January 2001 to May 2003. Rev Bras Otorhinolaryngol (Engl Ed) 2005;71:18‑22.
17. Daneshbod K, Bhutta RA, Sodagar R. Pathology of tonsils and adenoids: A study of 15,120 cases. Ear Nose Throat J 1980;59:466‑7.
18. Williams MD, Brown HM. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Hum Pathol 2003;34:1053‑7.
19. Ibekwe MU, Onotai LO. Routine histopathologic evaluation of adenoidectomy/or tonsillectomy specimens in Nigerian children: How relevant? J Med Med Sci 2012;3:179‑83.
20. Adoga AS, Ma An DN, Nuhu SI. Is routine histopathology of tonsil specimen necessary? Afr J Paediatr Surg 2011;8:283‑5.
21. Rebechi G, Pontes TE, Braga EL, Matos WM, Rebechi F, Matsuyama C, et al. Are histologic studies of adenotonsillectomy really necessary? Int
Arch Otorhinolaryngol 2013;17:387‑9.
22. Moloney JR, John DG, Jagger C. Age, sex, ethnic origin and tonsillectomy. J Laryngol Otol 1988;102:649‑51.
23. Thorp MA, Isaacs S, Sellars SL. Tonsillectomy and tonsillitis in cape town – Age and sex of patients. S Afr J Surg 2000;38:62‑4.
24. Ikram M, Khan MA, Ahmed M, Siddiqui T, Mian MY. The histopathology of routine tonsillectomy specimens: Results of a study and review of literature. Ear Nose Throat J 2000;79:880‑2.
25. Gates GA, Folbre TW. Indications for adenotonsillectomy. Arch Otolaryngol Head Neck Surg 1986;112:501‑2.
26. Parker NP, Walner DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2011; 75: 282‑5.
27. Sadeghi‑Shabestari M, Jabbari Moghaddam Y, Ghaharri H. Is there any correlation between allergy and adenotonsillar tissue hypertrophy?
Int J Pediatr Otorhinolaryngol 2011;75:589‑91.
28. Adeyemo A, Okolo C, Ogunkeyede S. Evaluation of histopathology examination of routine tonsillectomy and adenoidectomy specimens
in developing countries. J Pediatr Sci 2011;3:e96.
29. Dohar JE, Bonilla JA. Processing of adenoid and tonsil specimens in children: A national survey of standard practices and a five‑year review
of the experience at the children’s hospital of Pittsburgh. Otolaryngol Head Neck Surg 1996;115:94‑7.
30. Moore KL. Embriologia Clinica. 4th ed. Rio de Janeiro: Guanabara Koogan, 1996; 259.
31. Mohamad I, Hassan S, Salim R. The routine histopathological examination of tonsillectomy specimens at hospital Universiti Sains Malaysia – A retrospective study and its implication. Malays J Med Sci 2007;14:53‑5.
32. Beaty MM, Funk GF, Karnell LH, Graham SM, McCulloch TM, Hoffman HT, et al. Risk factors for malignancy in adult tonsils. Head Neck 1998;20:399‑403.
33. Sodagar R, Mohallatee EA. Necessity of routine pathological examination of tonsils. Eye Ear Nose Throat Mon 1972;51:229‑30.
34. Endo LH, Trevisan MA, Horn LS. Actinomycosis of palatal amyloids value of routine histochemical examination. Rev Bras Otorrinolaringol 1981;47:122‑6.
35. Alvi A, Vartanian AJ. Microscopic examination of routine tonsillectomy specimens: Is it necessary? Otolaryngol Head Neck Surg 1998; 119: 361‑3.
36. FAO. FAOSTAT, Food Security Statistics, Nigeria. Food and Agricultural Organisation of the United Nations, Rome; 2006. Available from: http://www.fao.org/faostat/foodsecurity/Countries/EN/Nigeria_e.pdf. [Last accessed on 2018 Aug 10]