ABSTRACT
In most ear, nose, and throat services, it is routine to send the material extracted from tonsillectomy for histologic study to research malignancy, to analyze suspect material, or to provide medical-legal documentation. Recent studies have shown that this routine analysis is dispensable. Objective: To evaluate the actual need and perform a costbenefit analysis of routine histopathologic examination in tonsillectomy with no signs or symptoms of malignancy. Methods: A retrospective observational study evaluated the charts of patients undergoing adenotonsillectomy, tonsillectomy, or adenoidectomy from January 2008 to September 2009 at the Institute of Otorhinolaryngology CEMA-SP. Costs of this test for the public health system were analyzed and the literature reviewed. Results We studied 281 patients between 2 and 22 years of age; 142 (50.5%) were male and 139 (49.5%) were female. Of the surgeries, 201 were adenotonsillectomies (71.5%), 41 were tonsillectomies (14.5%), and 39 were adenoidectomies (14%). The most common indication for surgery was recurrent infection (63.3%). None of study patients had clinical suspicion of malignancy. The tests showed a cost of R$20.03 per tonsil analyzed. Conclusion: Routine histopathologic examination in patients undergoing adenotonsillectomy with no signs or symptoms of malignancy is dispensable and increases the cost of the surgeries...
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Adenoidectomy , Tonsillar Neoplasms , Tonsillectomy , Cost-Benefit AnalysisABSTRACT
Introdução: Entre os distúrbios já rastreados ao nascimento, a perda auditiva (PA) é mais prevalente. Esforços têm sido feitos para identificação e tratamento precoces por meio de programas de triagem auditiva neonatal (TAN). A literatura sobre o tema demonstra a efetividade, taxas de exames falsos positivos e custos dos programas. O objetivodeste trabalho é apresentar os aspectos atuais da triagem auditivano país através da revisão de artigos sobre o tema. Conclusão: Os programas de triagem auditiva neonatal universal, mesmo com taxas de sucesso, apresentam algumas dificuldades a serem resolvidas.
Introduction: Hearing loss is more prevalent than other birth defects for which there is mandated screening. Many efforts have been made towards early identification and intervention by universal newborn hearing screening (UNHS) programs. The objective of this paper is to present current aspects of UNHS in Brazil by a review of articles about the subject. Conclusion: Reports from screening programs demonstratethe effectiveness, false-positive rates, and program costs. Despite the success rates of the UNHS, there are a few difficulties yet to be resolved.