What is Tonsillectomy?
Tonsillectomy is a surgical procedure which removes the palatine tonsils, generally following chronic tonsillitis or tonsillitis resulting in other complications, such as breathing difficulties.
It is one of the most commonly performed surgical procedures in children. Similarly, adenotonsillectomy is the surgical removal of both the palatine tonsils and the adenoids.
The tonsils and adenoids are a part of our immune system which is critical in protecting us against infection and illness. So, what effects, if any, do tonsillectomy and adenotonsillectomy have on the immune system?
Effect of tonsillectomy on the immune system
The immune system effects of tonsillectomy and adenotonsillectomy is a much debated topic in the medical literature. IgA is an antibody that is commonly found in the secretions of the mucous membranes, including in saliva and nasal secretions. IgA in the saliva and nasal secretions acts a defence against pathogens, which can enter the body via inhalation, food and drink. Studies have reported decreases in the level of IgA in the months following adenotonsillectomy; but the level of IgA was still within the normal range. There have also been reports of recovery of IgA in the secretions to an extent. IgG is another antibody produced by the tonsils and adenoids. Studies have also indicated a drop in levels of IgG following adenotonsillectomy, but as with IgA, the drop was within normal ranges and recovered in the months post-operation. Whilst there is controversy surrounding the topic, the drop in IgG and IgA post-tonsillectomy and adenotonsillectomy does not appear to have any significant effects.
In addition, the adenoids and tonsils are also involved in what is known as the ‘cell-mediated immune response’. The tonsils contain T lymphocytes, which are white blood cells which are important in our response to viruses. As with changes to IgA and IgG following adenotonsillectomy, the changes to cell mediated immunity is a debated topic. However, the majority of studies report no decrease in cell-mediated immunity after tonsillectomy and adenotonsillectomy. Some studies report increases in CD8 T cells, a subtype of T lymphocyte involved in killing infected cells.
Tonsillectomy has no significant effect on the immune system
To conclude, the immune effect of tonsillectomy and adenotonsillectomy is a debatable topic and requires more research. However, the majority of the evidence suggests that whist there may be minor short-term decreases in immunity, there are no major detrimental immune system effects resulting from the procedures. The current evidence suggests that tonsillectomy has no significant effect on the immune system in general.
If you have questions about tonsillitis or tonsillectomy and the effect of tonsillectomy on the immune system, contact your local doctor who will arrange for you to see an ear nose and throat surgeon.