Skip to main content
SpringerLink
Log in

Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children

  • Original Paper
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Immunological functions of the tonsils and possible effects of their removal are still controversial. One reason for this is the lack of long-term follow-up investigations after tonsillectomy. In the present study selected parameters of the cellular and Immoral immune systems of 160 children 0.5–11 years after tonsillectomy (mean 6.6 ± 2.1 years) were compared to those of 302 age-matched non-tonsillectomized children. In tonsillectomized children the incidence of infections of the upper respiratory tract was not increased compared to the non-tonsillectomized control group. Slightly increased percentages of CD 21+ cells, raised counts of CD4+ cells, absolute and relative increases in DR+ cells and a raised CD4+ DR count was found mainly in tonsillectomized boys, while lymphocyte subpopulations of tonsillectomized girls remained unaffected. Tonsillectomized children had lower IgA levels, but the complement system was not altered in either sex. These findings show that while tonsillectomy may lead to certain changes in the cellular and humoral immune systems, these alterations are clinically insignificant and no increased frequency of immunomodulated diseases should be expected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Astruc J, Toubin RM (1992) Recurrent pharyngitis. Indications for tonsillectomy. Rev Prat 42:298–301

    Google Scholar 

  2. Cantani A (1992) Arguments against routine adenotonsillectomy (letter) Immunol Today 13:419

    Google Scholar 

  3. Cantani A, Bellioni P, Salvinelli F, Buscino L (1986) Serum immunoglobulins and secretory IgA deficiency in tonsillectomized children. Ann Allergy 57:413–416

    Google Scholar 

  4. Carbonaro V, Penno A, Accorsi C, Fadalti ML, Licata E, Cacciabue F, Bisi O (1991) Chronic tonsillitis in children: a bacterial study in connection with benzathine penicillin treatment and the role of bacterial flora in tonsillar hypertrophy. Acta Otorhinolaryngol Ital 11:497–504

    Google Scholar 

  5. Charnock DR, Chapman GD, Taylor RE, Wozniak A (1992) Recurrent tonsillitis. The role of Chlamydia and Mycoplasma. Arch Otolaryngol Head Neck Surg 118:507–508

    Google Scholar 

  6. D'Amelio R, Palmisano L, Le Moli S, Seminara R, Aiuti F (1982) Serum and salivatory IgA levels in normal subjects: a comparison between tonsillectomized and non-tonsillectomized subjects. Int Arch Allergy Appl Immunol 68:256–259

    Google Scholar 

  7. Donati F, Pfammatter JP, Mauderli M, Vassella F (1991) Neurologische Komplikationen nach Tonsillektomie. Schweiz Med Wochenschr 121:1612–1617

    Google Scholar 

  8. Donovan R, Soothil JF (1973) Immunological studies in children undergoing tonsillectomy. Clin Exp Immunol 14:347–357

    Google Scholar 

  9. Francois M, Bingen EH, Lambert-Zechovsky NY, Mariani-Kurkdjian P, Nettet JB, Narey P (1992) Bacteremia during tonsillectomy. Arch Otolaryngol Head Neck Surg 118:1229–1231

    Google Scholar 

  10. Friday GA, Paradise JL, Rabin BS, Colborn DK, Taylor FH (1992) Serum immunoglobulin changes in relation to tonsil and adenoid surgery. Ann Allergy 69:225–230

    Google Scholar 

  11. Gaffney RJ, Walsh MA, NcShane DP, Cafferkey MT (1992) Post-tonsillectomy bacteraemia. Clin Otolaryngol 17:208–210

    Google Scholar 

  12. Gates GA, Folbre TW (1986) Indications for adenotonsillectomy. Arch Otolaryngol Head Neck Surg 112:501

    Google Scholar 

  13. Gledovic Z, Radovanovic Z (1991) History of tonsillectomy and appendectomy in Hodgkin's disease. Eur J Epidemol 7:612–615

    Google Scholar 

  14. Gorney AJ (1978) Indications for tonsillectomy (letter). N Engl J Med 298:1318

    Google Scholar 

  15. Gray LP (1977) The T' and A' problem — assessment and reassessment (letter). J Laryngol Otol 91:11

    Google Scholar 

  16. Herkner KR, Salzer H, Böck A, Mühl A, Tsaka T, Steger H, et al (1992) Pediatric and perinatal reference intervals for immunoglobulin light chains lambda and kappa. Clin Chem 38:548–550

    Google Scholar 

  17. Jensen JH, Larsen SB (1991) Treatment of recurrent acute tonsillitis with clindamycin. An alternative to tonsillectomy? Clin Otolaryngol 16:498–500

    Google Scholar 

  18. Lal H, Sachdeva OP, Mehta HR (1984) Serum immunoglobulins in patients with chronic tonsillitis. J Laryngol Otol 98:1213–1216

    Google Scholar 

  19. Langman AW, Kaplan MJ (1987) Hodgkin's disease and TE. Otolaryngol Clin North Am 20:399–404

    Google Scholar 

  20. Lenander LM, Tenovuo J, Puhakka HJ, Malvaranta T, Ruuskanen O, Meurman O, Meurman P, Vilja P (1992) Salivatory antimicrobial proteins and mutans streptococci in tonsillectomized children. Pediatr Dent 14:86–91

    Google Scholar 

  21. McGowan FX, Kenna MA, Fleming JA, O'Connor T (1992) Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurity. Pediatr Pulmonol 13:222–226

    Google Scholar 

  22. Ming De Ying (1988) Immunological basis of indications for tonsillectomy and adenotomy. Acta Otolaryngol (Stock) 454:279–285

    Google Scholar 

  23. Moreno PM, Sanchez M, Sainz M, Gutierrez F (1992) Changes in immunological response in tonsillectomized children. II. Decreased cellular response. Clin Otolaryngol 17:380–382

    Google Scholar 

  24. Ogra PL (1971) Effect of tonsillectomy and adenotomy on naso-pharyngeal antibody responsis to poliovirus. N Engl J Med 284:59–64

    Google Scholar 

  25. Pardise JL (1992) Etiology and management of pharyngitis and pharyngotonsillitis in children: a current review. Ann Otol Rhinol Laryngol [Suppl] 155:51–57

    Google Scholar 

  26. Pardise JL, Bluestone CD, Bachmann RN (1984) Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized clinical trials. N Engl J Med 310:674–678

    Google Scholar 

  27. Prusek W, Agopsowics T Podwysocka M (1983) T and B lymphocytes in peripheral blood and tonsils of children after tonsillectomy. Arch Immunol Ther Exp 31:489–496

    Google Scholar 

  28. Sainz M, Gutierrez F, Moreno PM, Munoz C, Ciges M (1992) Changes in immunologic response in tonsillectomized children. I. Immunosuppression in recurrent tonsillitis. Clin Otolaryngol 17:376–379

    Google Scholar 

  29. Scadding GK (1990) Immunology of the tonsil: a review. J R Soc Med 83:104–107

    Google Scholar 

  30. Tom LW, DeDio RM, Cohen DE, Wetmore RF, Handler SD, Potsic WP (1992) Is outpatient tonsillectomy appropriate for young children? Laryngoscope 102:277–280

    Google Scholar 

  31. Vianna NJ, Greenwald P, Davies JNP (1971) Tonsillectomy and Hodgkin's disease. Lancet II: 168–169

    Google Scholar 

  32. Yadav RS, Yadav SP, Lal H (1992) Serum immunoglobulin E levels in children with chronic tonsillitis. Int J Pediatr Otolaryngol 14:131–134

    Google Scholar 

  33. Yardley MP (1992) Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case procedures? J Laryngol Otol 106:299–300

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University Hospital, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    A. Böck

  2. Department of Pulmonology, Hospital Lainz, Wolkersbergenstrasse 1, A-1030, Vienna, Austria

    W. Popp

  3. Ludwig Boltzmann Institute for Pediatric Endocrinology and Immunology, University Hospital, Währinger Gürtel 18-20, Vienna, Austria

    K.R. Herkner

Authors
  1. A. Böck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Popp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K.R. Herkner
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Böck, A., Popp, W. & Herkner, K. Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children. Eur Arch Otorhinolaryngol 251, 423–427 (1994). https://doi.org/10.1007/BF00181969

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00181969

Key words

Search

Navigation