Each year, more than half a million children in the United States undergo tonsillectomy. Most of these procedures are performed for either sleep-disordered breathing or recurrent infections. Despite the frequency with which the procedure is performed, there is little consensus on how the resulting specimens should be handled. Most of the time, the tonsils are sent to a pathologist, who looks for evidence of more serious medical problems, such as unsuspected lymphoma.Pathologists examine tonsillectomy specimens in two ways: a visual, or "gross," examination and microscopy. Microscopic examination is nearly three times more expensive than visual inspection. According to a 2001 survey of American Academy of Otolaryngology members, 42% of specimens receive gross analysis, 38% are examined under the microscope, and 20% are discarded without examination.
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