Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and systemic immunological consequences of removing adenotonsillar tissue, based on changes in immunoglobulin (Ig) levels, T and B lymphocyte counts, and frequency of pre- and postoperative upper airway infections. Six studies looking at short-term effects and six studies looking at long-term effects were included.
In the short term, only one study showed a significant postoperative decrease in IgA, IgM and IgG levels, as well as cytotoxic T-lymphocyte count. Two studies noted both a significant decrease in IgG levels and a significant increase in T-helper cells. In the long term, there was no significant change in Ig levels or lymphocyte counts after adenotonsillectomy.
The authors concluded that there is no evidence that adenotonsillectomy compromises the immune system in either the short or long term. Adenotonsillectomy has been proven to improve quality of life and reduce the frequency of upper airway infections. The results of this study are beneficial in reassuring patients preoperatively that there is no risk of immunocompromise after adenotonsillectomy.
