gms | German Medical Science

Background: In pre-school children suffering from pure non-inflammatory hyperplasia of the tonsils tonsillotomy instead of tonsillectomy is newly suggested as a recommendable alternative. The only possibility to differentiate non-inflammatory hyperplasia from chronic tonsillitis preoperatively is the medical history. Therefore the question was raised, whether and to what degree the medical history of the children correlates with the histological diagnosis.

Patients and Methods: In a prospective study 50 children admitted to our department for tonsillectomy were grouped according to the number of acute tonsillitis they had been suffering from prior to admission: group I = 0; group II = up to 2; group III = > 2 tonsillitis/year. These groups were then compared with the histological diagnosis of the removed tonsils classified in (1) pure hyperplasia, (2) chronic inflammation, (3) hyperplasia with chronic inflammation without peritonsillar scarring and (4) with peritonsillar scarring.

Results: In group I (19 patients) the histological type (1) was found in 2, type (2) in 4, (3) in 10 and (4) in 3 children. Group II (7 children) showed type (1) once, type (2) three times, type (3) twice and type (4) once. Group III (24 children) revealed type (1) in 4, type (2) in 6, type (3) in 12 and type (4) in 2 cases.

Conclusion: Results show that the medical history of tonsillectomy children does not correlate with the histological diagnosis. In other words: the medical history as reported by the parents of the children appears to be inappropriate for a differential diagnosis between non-inflammatory hyperplasia of the tonsils and chronic tonsillitis.