Is it Effective and Cost-saving to Send all Tonsillectomy Specimens for Histopathological Examinations?

Introduction:The present study aimed to investigate the necessity or unnecessity of sending all tonsillectomy specimens for pathological examinations in Shiraz, Iran; moreover, it examined malignancies, cost-saving, causes, and the ways to prevent sending all specimens. Materials and Methods:In the first retrospective phase of the study, a checklist was used to gather demographic, clinical, and cost information of ۱۸,۴۳۷ tonsillectomy specimens during ۲۰۰۴-۲۰۱۸ in Shiraz, Iran. In order to estimate the cost of each pathology specimen, the cost components, including human resources costs and consumables, were collected in the private and public sectors separately and divided by the number of cases performed. Finally, the financial burden resulting from these services (in the study centers) was calculated by multiplying each item's cost by the total number of these services. Results:Out of the total ۱۸,۴۳۷ histopathology specimens examined, only ۱۱۸ (۰.۶۴%) samples were identified with unusual diagnoses, of which ۶۶ (۵۶%) cases had malignant tumors, and the remaining ۵۲ (۴۴%) samples included benign tumors (n=۴۱), infections (n=۲), and other problems (n=۹). The second phase results also indicated that according to the ear, nose, and throat experts, the rules and regulations governing the country's health system and the suspicion of tumors were the main reasons for sending tonsil specimens for pathological examinations. Generally, the annual cost-saving rates in the studied public and private centers were ۸۷,۹۱۹ and ۱۷۹,۵۳۰ purchasing power parity, respectively.Conclusions:According to the results, sending tonsillectomy specimens should only be limited to nonroutine ones for economic-clinical reasons.

Keywords:

Aspirin Intolerance , Asthma , Desensitization , Endoscopic sinus surgery , Nasal Polyps , Sinusitis