Short- and long-term impacts of adenoidectomy with/without tonsillectomy on immune function of young children <3 years of age

Abstract

To investigate the short- and long-term impacts of adenoidectomy with/without tonsillectomy on the immune functions of young children < 3 years of age. This longitudinal prospective study included 40 pediatric patients (age <3 y) undergoing adenoidectomy with/without tonsillectomy for snoring and sleep apnea. Serum immunoglobulin IgA, IgG, IgM, complement C3, and C4 levels were measured for the status of humoral immunity; CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, CD56+, CD3+CD4-CD8-, and CD3+CD4+CD8+ T cells were measured for the status of cellular immunity. Blood samples were taken at 3 time points: before surgery, 1 month after surgery (short-term), and 3 months after surgery (long-term). All patients were assessed for short-term outcome at 1-month postoperation, but only 30 patients were followed at 3 months after surgery. The incidence of recurrent respiratory tract infections and other immune-related conditions were recorded at each follow-up. The levels of IgA significantly decreased from the preoperative level at 1-month follow-up ( P < .05), but still within normal range. No significant changes were found in the levels of IgA, IgG, IgM, C3, C4, CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, CD56+, CD3+CD4-CD8-, and CD3+CD4+CD8+ T cell at 3-month follow-up in comparison with preoperative levels. There was also no episode of recurrent respiratory tract infection and other immune-deficiency conditions. Adenoidectomy with/without tonsillectomy may result in a reduction in individual antibodies in children <3 years of age, but did not show negative impacts on their immune functions. Also, the surgery does not lead to the increased risk of upper respiratory tract infection in these children.

Early tonsillectomy for severe immunoglobulin A nephropathy significantly reduces proteinuria

“…Furthermore, Yan et al reported that adenoidectomy with/without tonsillectomy in children less than 3 years of age does not lead to negative impacts on the immune system. 16 However, clinicians should inform the complications of tonsillectomy such as bleeding, pain, taste disorders, tooth damage, and residual tonsils to patients. The criteria for tonsillectomy should therefore be limited to severe cases that have sustained proteinuria of more than 0.3 g/day after multiple-drug therapy.…”

Relationship of endoplasmic reticulum stress with the etiopathogenesis of chronic tonsillitis and tonsillar hypertrophy in pediatric patients: a prospective, parallel-group study

“…Tonsil tissue, as a vital part of the Waldeyer ring, is an important component of the immune system located centrally at the entrance of respiratory and gastrointestinal systems, where pathogens, infectious agents, and allergens invading the upper respiratory tract rst encounter the immune system [1]. Tonsil tissue is a secondary lymphoid organ that exerts both humoral and cellular immunity functions against various antigens with speci c antibodies, B and T cell activities, and protects the body especially in young children [2]. Hence, in patients with tonsillitis, cellular, and humoral immune responses are stimulated together.…”

“…Hypertrophy may also occur following bouts of local or systemic infection. However, they may also undergo atrophy with chronic disease processes [2].…”

Tonsillectomy and the incidence of various types of cancer

“…Some studies with small sample sizes found that the initial immunological deficit following tonsillectomy in children becomes normal after 1 month [ 18 ], 6 months [ 19 ], and 54 months [ 20 ]. Similarly, a recent study concluded that the examined humoral and cellular immunity markers were not altered by adenoidectomy with/without tonsillectomy in children, nor did the surgery lead to an increased risk of infection, nor to immune-deficiency disorders in the 3 months following the operation [ 21 ].…”