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 |