Serdar ALTINAY, Şeyda BELLİ, Ümit TAŞKIN

Pediatrik Adenoidektomi/Adenotonsillektomi Olgularında Beklenmedik Malignite Oranları

Amaç: Yapılan meta-analiz ve gözden geçirme çalışmalarında, pediatrik adenotonsillektomilerde malignite oranlarının çok düşük bulunması histopatolojik incelemenin gereksiz zaman, emek ve ekonomik kayıplara neden olduğu yönünde şüpheler uyandırmaktadır. Bu çalışmada çocukluk çağı adenoidektomi/adenotonsillektomi olgularımızdaki malignite oranlarının belirlenmesi amaçlandı. Hastalar ve Yöntem: Çalışmaya 1.1.2010 ve 1.1.2013 tarihleri arasında Bağcılar Eğitim ve Araştırma Hastanesi’nde KBB polikliniğine başvuran ve klinik-radyolojik değerlendirmeleri sonucunda adenoid hipertrofisi tanısı konan çocuk hastalar alındı. Adenoidektomi/adenotonsillektomi yapılan 975 olgunun histopatolojik sonuçları retrospektif olarak incelendi. Bulgular: 975 pediatrik hastanın 545’i erkek, 430’u kız olup 495’ine %50,8 sadece adenoidektomi, 480’ine %49.2 adenotonsillektomi ameliyatı yapılmıştı. Kronik inflamasyon ve lenfoid hiperplazi birlikteliği en sık rastlanan bulgulardı. Histopatolojik incelemede hiçbir olguda beklenmedik malignite çıkmadı. Sonuç: Rutin pediatrik adenoidektomi/adenotonsillektomi materyallerinde malignite bulamasak da tüm örneklerin histopatolojik olarak incelenmesi gerektiğine inanıyoruz. Makroskopik değerlendirme ve klinik-radyolojiklaboratuvar bulguların araştırılması maliyet ve zaman kaybını azaltmada alternatif bir yol olabilir. Biz yinede hekimlerin gerek legal gerekse beklenmedik malignite tanısı gibi sorunlarla karşılaşmaması için postoperatif dönemde patolojik incelemeyi önemsemelerini öneriyoruz.

UNEXPECTED MALIGNANCY RATES IN CASES OF PEDIATRICADENOIDECTOMY / ADENOTONSILLECTOMY

Objective: The fact that the malignancy rates in pediatric adenotonsillectomies were regarded too low in the meta-analyses and reviews conducted leads to the suspicion that histopathological assessment gives rise to unnecessary loss of time, effort and money. The objective of this study was to determine the malignancy rates in our cases with childhood adenoidectomy/adenotonsillectomy. Patients & Methods: Pediatric patients who applied to the Ear,Nose&Throat ENT outpatient department of Bağcılar Education and Research Hospital between 1.1.2010 and 1.1.2013 and diagnosed with adenoid hypertrophy as a result of clinical-radiological examinations were included into the study. The histopathological results of 975 cases that underwent adenoidectomy/adenotonsillectomy were analyzed retrospectively. Results: Out of 975 pediatric patients 545 boys, 430 girls , 495 50.8% underwent only an adenoidectomy, while 480 49.2% underwent an adenotonsillectomy. The concomitance of chronic inflammation and lymphoid hyperplasia was among the symptoms encountered most frequently. No unexpected malignancy was detected in the histopathological assessment. Conclusion: Although we can’t identify the malignancy in routine pediatric adenoidectomy/ adenotonsillectomy materials we believe that all of the samples need to be analyzed as histologically. Macroscopic assessment and clinical-radiological and laboratory findings may be an alternative way to examine for reducing the cost and time loss. Nevertheless we recommend that the doctors care about the pathological examination in postoperative period for not to encounter with problems such as legal or an unexpected malignancy.

Keywords:

pediatrics adenoidectomy tonsillectomy, histopathology, unexpected malignancy.,

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