Systemic Immunoglobulin Changes Following Adenoidectomy, Tonsillectomy, and Adenotonsillectomy in Patients With Chronic Tonsillitis and Adenoiditis: A Prospective Study.

BACKGROUND

Chronic tonsillitis and adenoiditis are common inflammatory disorders of Waldeyer's ring that may lead to persistent systemic immune stimulation due to recurrent infection of tonsillar lymphoid tissue. Because the palatine tonsils and adenoids participate in mucosal immune defense and antibody production, concerns have occasionally been raised regarding the potential immunologic consequences of surgical removal of these structures.

METHODS

A prospective clinical investigation was conducted involving 100 participants, including 75 patients with chronic tonsillitis or adenoiditis and 25 healthy control subjects. Patients were categorized according to surgical treatment into adenoidectomy, tonsillectomy, and adenotonsillectomy groups. Serum concentrations of immunoglobulin G, immunoglobulin A, and immunoglobulin M were measured preoperatively and approximately one month following surgery.

RESULTS

Patients with chronic tonsillar disease demonstrated higher baseline immunoglobulin concentrations than healthy control subjects, consistent with persistent antigenic stimulation associated with chronic lymphoid inflammation. Following surgical treatment, significant reductions in serum immunoglobulin concentrations were observed, most prominently after tonsillectomy and adenotonsillectomy. The magnitude of these changes suggests that chronically inflamed tonsillar tissue contributes to sustained systemic humoral immune activation. Importantly, postoperative immunoglobulin concentrations remained within physiologic ranges.

CONCLUSIONS

Chronic tonsillar disease is associated with sustained systemic immune activation, and surgical removal of inflamed lymphoid tissue is associated with a short-term trend toward normalization of humoral immune parameters without evidence of physiologic immune impairment.