Is routine pathological examination required in South African children undergoing adenotonsillectomy?
نویسندگان
چکیده
OBJECTIVE We aimed to determine the incidence of abnormal pathological findings in the tonsils and/or adenoids of children undergoing tonsillectomy and/or adenoidectomy, and the incidence of tuberculosis of the tonsils and adenoids; suggest criteria to identify children at risk for adenotonsillar tuberculosis; and investigate the association between HIV and adenotonsillar abnormality, the cost-effectiveness of routine pathological examination of adenotonsillectomy specimens, and criteria to decide which specimens to send for histological examination. METHODS We undertook an 8-month prospective study on all children (< or =12 years) undergoing consecutive tonsillectomy or adenotonsillectomy (T&A) at Red Cross War Memorial Children's Hospital. Patients were assessed pre-operatively and tonsil sizes graded pre- and intra-operatively. Blood was taken for HIV testing, and all tonsils and adenoids were examined histologically. A cost-benefit analysis was done to determine the cost-effectiveness of adenotonsillectomy routine pathology. RESULTS A total of 344 tonsils were analysed from 172 children (102 boys, 70 girls); 1 patient had nasopharyngeal tuberculosis, and 1 lymphoma of the tonsils; 13 (7.6%) patients had clinically asymmetrically enlarged tonsils but no significant abnormal pathological finding. The average cost of detecting a clinically significant abnormality was R22 744 (R45 488 + 2 abnormalities). CONCLUSIONS The following criteria could improve cost-effectiveness of pathological examination of adenotonsillectomy specimens: positive tuberculosis contact at home, systemic symptoms of fever and weight loss, cervical lymphadenopathy >3 cm, suspicious nasopharyngeal appearance, HIV-positive patient, rapid tonsillar enlargement or significant tonsillar asymmetry. On our evidence, routine pathological investigation for South African children does not seem to be justified.
منابع مشابه
Patterns and Grade of Velopharyngeal Closure in Candidates for Adenotonsillectomy
Introduction: The most common type of velopharyngeal valve (VPV) closure is a matter of controversy.The aim of this study was to estimate the most common type of VPV closure, including identification of the type and grade of VPV closure among Egyptian children. Materials and Methods: This study included patients who were candidates for adenotonsillectomy. In these cases, video-nasoendoscopy an...
متن کاملAn Examination of Pre/Post-Adenotonsillectomy Obesity Indices in 3-10 Year Old Children in Mashad, Iran
Introduction: Adenotonsillectomy is one of the most frequent surgical operations on children, which may result in weight gain in a number ways, for instance, by increasing IGF-1 or decreasing respiratory hyperactivity. Materials and Methods: This was an intervention study with a control group, conducted on fifty 3-10-year-old children who had undergone adenotonsillectomy and on fifty childre...
متن کاملOsteitis of the apex of the third phalanx following foot trimming in a dairy cow.
An adult Ayrshire cow was presented with bilateral hind-limb lameness 5 weeks after routine claw trimming. Examination under intravenous regional anaesthesia revealed ulceration of the sole at the toe of both the right lateral and left medial claws of the hind limbs. Radiographic examination showed osteolysis and pathological fractures of the 3rd phalanx of both affected claws. Wooden blocks we...
متن کاملAre Histologic Studies of Adenotonsillectomy Really Necessary?
Introduction In most ear, nose, and throat services, it is routine to send the material extracted from tonsillectomy for histologic study to research malignancy, to analyze suspect material, or to provide medical-legal documentation. Recent studies have shown that this routine analysis is dispensable. Objective To evaluate the actual need and perform a cost-benefit analysis of routine histopath...
متن کاملThe effect of cuffed endotracheal tube on respiratory complication following adenotonsillectomy in children
Abstract Background: Uncuffed endotracheal tube(ETT) were considered for children less than 8 years. Meanwhile, aspiration around ETT in patients undergoing adenotonsillectomy is concerned.We compared cuffed versus uncuffed ETT regarding respiratory complications following adenotonsillectomy. Methods: 128 children aged 2-8 yr were divided to two groups of 64 each. Uncuffed and cuffed tubes w...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
دوره 99 11 شماره
صفحات -
تاریخ انتشار 2009