Histopathologic Evaluation of Routine Tonsillectomy Specimens in the Pediatric Population: Is it Necessary?

Controversy continues to exist regarding the necessity for routine histopathological examination of excised tonsil specimens. While otolaryngologists fear missing an unsuspected diagnosis such as presence of tonsil malignancy in one hand, and given the rare incidence of this event in children on the other hand, the cost–effectiveness ratio for routine microscopic analysis remains questionable. The purpose of this study was to evaluate the necessity of histopathologic examination for routine tonsillectomy. In this cross–sectional study we performed a retrospective evaluation of 97 pediatric patients who underwent tonsillectomy over one year period, from April 2004 to March 2005 at Imam Khomeini hospital of Ahwaz Jundishapur University of Medical Sciences. All patients aged less than 14 years and were randomly selected. The data collected from hospital files included age, sex, indication for surgery and the result of histopathologic examination of the resected specimen. There were 50 boys (51.6 %) and 47girls (49.4 %) with age distribution of 3 to 14 years (mean 8.96 years). The histopathological reports revealed no malignancies. The finding from this study suggest that following careful clinical evaluation by an experienced otolaryngologist pathologic evaluation of all specimens may not be necessary. Histopathological examination should be done in only selected cases with grossly asymmetric tonsils or in patients with a history of malignancy.