Clinical parameters predicting tonsillar malignancy.

European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
Avital FellnerLimor Muallem Kalmovich

Abstract

Tonsillectomy is indicated in unilateral tonsillar enlargement (UTE) to rule out malignancy, which eventually is found in about 1.4% of the patients. The aim of this study was to evaluate the presenting symptoms of patients who underwent tonsillectomy for UTE and identify parameters that are associated with an increased risk for malignancy, for better assessment and refinement of current management protocols. A retrospective chart review of adult patients with UTE who underwent tonsillectomy between 1/1/2006 and 31/12/2016 was conducted. Forty-one patients with a median age of 53 years were included. There were 20 (49%) females and 21 (51%) males. Sixteen (39%) patients were diagnosed as having tonsillar malignancy. Patients with malignancy were older than those in the benign group (p = 0.001), had a previous malignancy (p = 0.006), and were less likely to present as an incidental finding (p < 0.001). Lymphadenopathy, throat pain, suspicious appearance of tonsillar mucosa, and hard consistency were also found to be statistically significant findings in the malignancy group (p = 0.017, p = 0.001, p = 0.01 and p = 0.018, respectively). Multivariable regression showed age, appearance and adjacent tissue involvement to be independe...Continue Reading

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