Authors Year Origin Study Design N CT/MRI/PETCT N tonsillectomy Tonsil Pickup Overall Pickup Complications Recommendations
Podeur et al19 2020 France RS 63 Negative Ex, CT, PETCT, endoscopy 47 (UL/BL) 26% (12) (59% if HPV positive) 6% haemorrhage for tonsillectomy - Extended workup BL tonsillectomy +/- TBM HPV positive
Lee et al12
2020
USA
RS cohort
180
Negnegative ex and flexible laryngoscopy/mirror HPV status. PETCT (73.9%) prior to direct laryngoscopy with Biopsy
87 (36 BL/51 UL) some Biopsy (20 inc PT)
Tonsillectomy 32.2% (28/87) Overall tonsil: 51/92: 55.4%
51.1% (92/180) from surgery
Tonsillectomy and TORS TBM if negative
Waltonen et al13
2009
USA
RS
183
CT/PETCT variable but negative. PE and biopsy negative. UL and BL tonsillectomy
Mix of BL and UL and directed Bx
40.5% (34)
45.9% (84). If PETCT, PE & Biopsy +/- tonsillectomy: 59.6%
PETCT adj to directed Biopsy and BL tonsillectomy Some crossover previous study
Cianchetti et al14
2009
USA
RS
236
Negative Ex, CT/MRI.+/- FDG-DSPECT/FDG PET. Then PE directed biopsy. Mix negative and positive
72 IL BL 7 (79)
44.3% (35/79 PT) 46.8% (59/126 overall positive in Bx) 53.4% (126/236) (21/72 29.2% if all workup negative)
UL or BL should be inc in workup
Mendenhall et al20
1998
USA
RS
130
CT/MRI/SPECT
34
35.2% (12/34) Overall 43% (25) 43% (56/130) Positive PE & rad 65%
11 susp tonsil lesion workup. Tonsillectomy useful those with findings suggestive on workup
Lapeyre et al21
1997
France
?PS
87
IL tonsillectomy performed during endoscopic workup
87
26% (23/87) (31% in those single cervical LN)
Non specific
Tonsillectomy part of Dx workup in single cervical nodes subdigastric, mid-jugulo-carotid, or submandibular areas, or BL sub-digastric
Righi et al22 2005 USA RS 19 Negative Ex, flex NE, CT, PE random Biopsy IL 19 31.6% (6) IL tonsillectomy all patients with upper or mid jugular nodes