Abstract
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 histopathologic
examination in tonsillectomy with no signs or symptoms of malignancy.
Methods A retrospective observational study evaluated the charts of patients undergoing adenotonsillectomy,
tonsillectomy, or adenoidectomy from January 2008 to September 2009 at the Institute
of Otorhinolaryngology CEMA-SP. Costs of this test for the public health system were
analyzed and the literature reviewed.
Results We studied 281 patients between 2 and 22 years of age; 142 (50.5%) were male and
139 (49.5%) were female. Of the surgeries, 201 were adenotonsillectomies (71.5%),
41 were tonsillectomies (14.5%), and 39 were adenoidectomies (14%). The most common
indication for surgery was recurrent infection (63.3%). None of study patients had
clinical suspicion of malignancy. The tests showed a cost of R$20.03 per tonsil analyzed.
Conclusion Routine histopathologic examination in patients undergoing adenotonsillectomy with
no signs or symptoms of malignancy is dispensable and increases the cost of the surgeries.
Keywords
tonsillar neoplasms - tonsillectomy - adenoidectomy
