Is routine pathological examination required in South African children undergoing adenotonsillectomy?
| dc.contributor.author | Van Lierop, Anton | |
| dc.contributor.author | Prescott, C A J | |
| dc.date.accessioned | 2017-05-02T07:40:20Z | |
| dc.date.available | 2017-05-02T07:40:20Z | |
| dc.date.issued | 2009 | |
| dc.date.updated | 2016-01-07T10:56:42Z | |
| dc.description.abstract | 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 (≤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. | |
| dc.identifier | http://dx.doi.org/10.7196/SAMJ.2878 | |
| dc.identifier.apacitation | Van Lierop, A., & Prescott, C. A. J. (2009). Is routine pathological examination required in South African children undergoing adenotonsillectomy?. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/24225 | en_ZA |
| dc.identifier.chicagocitation | Van Lierop, Anton, and C A J Prescott "Is routine pathological examination required in South African children undergoing adenotonsillectomy?." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/24225 | en_ZA |
| dc.identifier.citation | van Lierop, A., & Prescott, C. (2009). Is routine pathological examination required in South African children undergoing adenotonsillectomy?. South African Medical Journal, 99(11), 805. | |
| dc.identifier.ris | TY - Journal Article AU - Van Lierop, Anton AU - Prescott, C A J AB - 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 (≤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. DA - 2009 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Is routine pathological examination required in South African children undergoing adenotonsillectomy? TI - Is routine pathological examination required in South African children undergoing adenotonsillectomy? UR - http://hdl.handle.net/11427/24225 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/24225 | |
| dc.identifier.vancouvercitation | Van Lierop A, Prescott CAJ. Is routine pathological examination required in South African children undergoing adenotonsillectomy?. South African Medical Journal. 2009; http://hdl.handle.net/11427/24225. | en_ZA |
| dc.language.iso | eng | |
| dc.publisher.department | Division of Otorhinolaryngology | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.source | South African Medical Journal | |
| dc.source.uri | http://www.samj.org.za/index.php/samj | |
| dc.title | Is routine pathological examination required in South African children undergoing adenotonsillectomy? | |
| dc.type | Journal Article | en_ZA |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |