Orkun EROĞLU, Erol KELEŞA, TURGUT KARLIDAĞ, İRFAN KAYGUSUZ, Cihan TÜRKER, ŞİNASİ YALÇIN

Tonsillektomi Endikasyonlarımızın Yeniden Gözden Geçirilmesi

Amaç: Kulak Burun ve Boğaz cerrahlarının en sık yaptığı operasyonlardan biri olan tonsillektomi ameliyatı ile ilgili literatürde endikasyon, etkinlik, hayat kalitesine etkisi ve postoperatif komplikasyonlar konusunda tartışmalar mevcuttur. Bu çalışmamızda kliniğimizde tonsillektomi operasyonu uygulanan hastaların dosyaları retrospektif olarak incelendi. Gereç ve Yöntem: Nisan 2004 - Ocak 2017 tarihleri arasında Fırat Üniversitesi Hastanesi Kulak Burun Boğaz Kliniği' nde tonsillektomi ve/veya adenotonsillektomi operasyonu yapılan 1433 hastanın arşiv materyalleri yaş, cinsiyet, endikasyon, histopatolojik tanıları ve postoperatif komplikasyon açısından retrospektif olarak analiz edildi. Bulgular: Tonsillektomi yapılan 1433 hastanın 965' i (%67.3) 18 yaş altıydı ve yaş ortalamaları 9.7, 468' i (%32.6) ise 18 yaşından büyüktü ve yaş ortalaması 32.5 idi. Hastaların 198' si (%13.8) hava yolu obstrüksiyonu bulgularına neden olan hipertrofik tonsil nedeniyle opere edilmişti. 648 (%45.2) hasta kronik ve/veya rekürren enfeksiyon nedeniyle opere edilirken, 550 (%38.3) hasta hem hava yolu obstrüksiyonu bulgularına neden olan hipertrofik tonsil hem de kronik ve/veya rekürren enfeksiyon nedeniyle opere edilmişti. Tonsil malignensi şüphesiyle opere edilen hasta sayısı 27 (%1.8) idi. Diğer nedenlerle opere edilen hasta sayısı ise 11 (%0.7) idi. Sonuç: Çalışmamızda kronik ve/veya rekürren enfeksiyon nedeniyle tonsillektomi, tonsillektomi endikasyonları içerisinde ilk sırada yer almıştır. Kronik ve/veya rekürren enfeksiyon nedeniyle tonsillektomi endikasyonunun en sık endikasyon olması hasta seçiminin güvenilirliği konusunda soru işaretleri oluşturmaktadır. Daha sağlıklı operasyon kararı verebilmek için hasta takibinin ve dökümantasyonun özenle yapılmasını önermekteyiz.

Review of Our Tonsillectomy Indications

Objective: There is not a consensus in the literature regarding indications, efficacy, quality of life and postoperative complications of tonsillectomy surgery, which is one of the most common operations performed by otorhinolaryngologists. The data of the patients who underwent tonsillectomy operation in our clinic were retrospectively reviewed. Material and Method: Archival materials of 1433 patients who underwent tonsillectomy and/or adenotonsillectomy operations at Fırat University Department of Otorhinolaryngology between April 2004 and January 2017 were analyzed retrospectively in terms of age, sex, indications, histopatho-logic diagnosis and postoperative complications. Results: Of the 1433 patients who underwent tonsillectomy, 965 (67.3%) were below 18 years of age and average age of them was 9.7 and 468 (32.6%) were >18 years and mean age was 32.5. 198 patients (13.8%) were operated due to hypertrophic tonsil causing airway obstruction findings. Of the 648 patients (45.2%) who were operated for chronic and / or recurrent infections, 550 (38.3%) patients had hypertrophic tonsils causing airway obstruction and also had chronically and / or recurrent infections. Twenty-seven (1.8%) patients were operated due to suspicion of tonsil malignancy. The number of patients selected for other reasons was 11 (0.7%). Conclusion: In our study, tonsillectomy was the first indication due to chronic and / or recurrent infection. The most frequent indication for tonsillec-tomy indication due to chronic and/or recurrent infection is the question of the reliability of patient selection. We recommend that the follow-up of the patient and the documentation should be done carefully in order to make a decision about a healthier operation.

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