Histopathological Examination of Tonsillectomy Specimens in Karbala, Iraq

Abstract

Background: Tonsillectomy with or without adenoidectomy is the most common major surgical procedure performed by otorhinolaryngologist. There is no clear unanimity on whether benign looking tonsil and adenoids specimens should be examined histopathologically.

Objectives: To evaluate the real need of routine histopathological examination in tonsillectomy without signs or symptoms of malignancy.

Methods:  Tow hundred-thirty nine patients who underwent tonsillectomy due to various indications at Department of Otolaryngology,  Al-Hussian Teaching Hospital, Karbala during the period May 2016 to September 2017, histopathological examination of tonsillectomy specimens were done for all patients.

Results:  A total of 239 patients submitted to tonsillectomy, there were 135 (56.5%) males and 104 (43.5%) females patients (M/F 1.3:1). Ten patients (4.2%) were have normal tonsil size, the rest of the patients, 226 (94.6%), have large tonsil. One-hundred thirty four (56.1%) patients have enlarged lymph nodes. Halitosis present in 76 (31.8%) of the patients. One-hundred thirty two (55.2%) patients have congested pillar. Recurrent tonsillitis occurs in 229 (95.8%) of our patients more than 4 times per a  year. One-hundred seventy six (73.6%) patients have a history of associated fever. Only one patient gave a history of peritonsillar abscess. Obstructive sleep apnea and snoring occurs in 157 (65.7%) of our patients. Only 2 (0.9%) patients diagnosed  as B cell lymphoma, one male 35 years old the other female 40 years old. 

Conclusions: Histopathological examination is only needed for patients with preoperative suspicion of malignancy. Gross examination may be a good alternative since it is cost effective and not time consuming.

Keywords:  Tonsillectomy specimens, histopathology, malignancy, routine, hypertrophy.