{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T05:31:09Z","timestamp":1791091869538,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,1,31]],"date-time":"2011-01-31T00:00:00Z","timestamp":1296432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Evaluate the utility and explore the cost\u2010effectiveness of mandatory gross or pathologic analysis of routine tonsillectomy specimens in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care children\u2019s hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Retrospective case series of results of pathologic analysis of tonsillectomy specimens from all pediatric patients who underwent tonsillectomy between 1996 and 2008 (n = 5235). The results of pathologic evaluation of routine and nonroutine specimens were evaluated, and an economic analysis of alternative methods of specimen handling was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Zero cases of unsuspected pathology were identified on planned gross specimen evaluation (n = 4186), resulting in an estimated prevalence of 0 to 0.00088 (95% confidence interval [CI]). Positive pathologic findings on microscopic analysis (n = 1066) were only identified in posttransplant patients (10\/63; 95% CI, 0.079\u20100.27) and cases of surgeon suspicion (8\/78; 0.045\u20100.19). No cases were identified among the 17 undergoing microscopic pathologic analysis on the basis of pathologist suspicion on gross evaluation (95% CI, 0\u20100.20). From an economic standpoint, microscopic evaluation of routine pediatric tonsillectomy specimens appears to be superior to gross evaluation but with an estimated cost of $766 500 per case of unsuspected lymphoma identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study identifies a very low prevalence of unsuspected pathology on gross pathologic analysis of routine tonsillectomy specimens in children. Exploration of the cost implications suggests that such a practice is not a cost\u2010effective use of limited health care resources. Microscopic examination is appropriate for posttransplantation patients and in cases of surgeon suspicion.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599810393875","type":"journal-article","created":{"date-parts":[[2011,1,31]],"date-time":"2011-01-31T22:51:17Z","timestamp":1296514277000},"page":"778-783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Pathologic Evaluation of Routine Pediatric Tonsillectomy Specimens"],"prefix":"10.1002","volume":"144","author":[{"given":"Marc E.","family":"Nelson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Pediatric Otolaryngology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. J.","family":"Gernon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Pediatric Otolaryngology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Pediatric Otolaryngology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B.","family":"McHugh","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc C.","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Pediatric Otolaryngology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,1,31]]},"reference":[{"issue":"139","key":"e_1_2_8_2_2","article-title":"Ambulatory and inpatient procedures in the United States, 1996","volume":"13","author":"Owings MF","year":"1998","journal-title":"Vital Health Stat"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(96)70143-2"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.119862"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016486509127018"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1967.00760040682016"},{"key":"e_1_2_8_7_2","first-page":"229","article-title":"Necessity of routine pathological examination of tonsils","volume":"51","author":"Sodagar R","year":"1972","journal-title":"Eye Ear Nose Throat Mon"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318093ee4e"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/108.2.158"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200112000-00017"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.10.028"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540160061034"},{"key":"e_1_2_8_13_2","first-page":"103","article-title":"Routine pathological evaluation after tonsillectomy: is it necessary?","volume":"2","author":"Dewil B","year":"2006","journal-title":"B\u2010Ent"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-005-1302-6"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.05.005"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200406000-00027"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.7.767"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.79.3.399"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/S0046-8177(03)00408-8"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0869-4"},{"key":"e_1_2_8_21_2","first-page":"367","article-title":"Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsils?","volume":"97","author":"Lierop AC","year":"2007","journal-title":"S Afr Med J"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2008.11.001"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(98)70079-8"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20342"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10024-005-0043-6"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(01)00633-4"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599810393875","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599810393875","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599810393875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:41:48Z","timestamp":1760960508000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599810393875"}},"subtitle":["Analysis of Cost\u2010Effectiveness"],"short-title":[],"issued":{"date-parts":[[2011,1,31]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2011,5]]}},"alternative-id":["10.1177\/0194599810393875"],"URL":"https:\/\/doi.org\/10.1177\/0194599810393875","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1,31]]},"assertion":[{"value":"2010-09-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-11-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}