Authors Year Origin Study Design N Workup N tonsillectomy Tonsillectomy Pickup Synchronous/Contralateral Complications Recommendations
Podeur et al19 2020 France RS 63 Negative Ex, CT, PETCT, endoscopy 47 (UL/BL) 26% (59% if HPV positive) CL 8.3% 6% for tonsillectomy - Haemorrhage - return to theatre Extended workup BL tonsillectomy +/- TBM HPV positive
Lee et al12
2020
USA
RS cohort
180
Negative ex and flexible laryngoscopy/mirror HPV status. PETCT (73.9%) prior to direct laryngoscopy with Biopsy
87 (36 BL/ 51 UL)
Tonsillectomy 32.2% (28/87) Overall tonsil: 51/92: 55.4%
CL 2% (2) BL 6% (6) (location not specified)
Tonsillectomy and TORS TBM if negative
Rokkjaer & Klug23
2018
Denmark
RS
211
Tonsillar Ca pts
180 BL, 31 UL with CL Biopsy. 14 Biopsy
3.3% (7/211) Synchronous BL 2.3% (4/171) CL (2 had dysplasia)
BL tonsillectomy in suspected/proven tonsillar cancer and CUP
Saber et al24 2017 Denmark RS 1119 Tonsillar Ca pts 12 Bi tonsillar SCC. 9 of which were CUP Bilateral 9% (2012-2014 when tonsils totally embedded) particularly HPV. !% whole study time Bilateral tonsillectomy
Kothari et al25
2007
UK
RS
24
MRI if negative PETCT
BL tonsillectomy in 22
BL 22.7% (5/22) 2 had IL pos findings PETCT
BL tonsillectomy
Koch et al26 2001 USA Case series 41 39% (16) 12.5% CL (2/16), 12.5% BL (2/16) BL tonsillectomy
Tanzler et al5 2014 USA RS 156 Negative Ex, Ix and PE 71 39% (28/71) 6% (2/34) BL (not all had CL sampled) Palatine tonsillectomy, consider BL
Cianchetti et al14
2009
USA
RS
236
Negative workup: Ex,CXR, CT/MRI.+/- FDG-DSPECT/FDG PET. Then PE directed Biopsy. Mix negative and positive
IL or BL 79
44.3% (35/79) Overall 46.8% (59/126)
4.76% (6/126) synchronous (2.8% BL tonsils 1/59 with tonsillar Cancer)
UL or BL should be inc in workup
McQuone et al11
1998
USA
RS
37
Negative Ex and radiological, endoscopy
IL7, BL 16: 23
39% (9/23)
11.1% (1/9) BL with tonsillectomy, 9.1% overall (1/11)
BL PT n=2 (100%) of positive Biopsy pts had palpable asymmetry