Affordable Access

Is routine pathological examination required in South African children undergoing adenotonsillectomy?

Health and Medical Publishing Group
Publication Date
  • Biology
  • Economics
  • Medicine


Objective. We aimed to determine the incidence of abnormalpathological 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 (.12 years) undergoing consecutive tonsillectomy or adenotonsillectomy (T&A) at Red Cross War Memorial Childrenfs 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 nasopharyngealappearance, 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.

There are no comments yet on this publication. Be the first to share your thoughts.


Seen <100 times

More articles like this

Is routine pathological examination required in So...

on South African medical journal... November 2009

Routine omentectomy is not required in children un...

on Advances in peritoneal dialysi... 1995

Routine pathological examination of surgical speci...

on The Journal of Bone and Joint... June 2002

Clinico-pathological features of the nephrotic syn...

on The Quarterly journal of medic... January 1979
More articles like this..