What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

  • Josephat Maduabuchi Chinawa College of Medicine, Department of Pediatrics, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria
  • Awoere Tamunosiki Chinawa Enugu State University Teaching Hospital, Enugu, Nigeria
  • James Akpe Department of Ortholaryngology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria
  • Lovelyn Kelvin-Iloafu Department of Management, Faculty of Business Administration, University of Nigeria, Enugu Campus, Enugu State, Nigeria
  • Vivian Onukwuli College of Medicine, Department of Pediatrics, University of Nigeria, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria
Keywords: Adenoids; tonsils; children; histology

Abstract

Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histology. Objectives: this study is aimed at determining the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, one adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper air way obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio.

Published
2019-04-18
Section
Articles

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eISSN: 1937-8688