Differential expression of Immunoglobulin A in the adenoids of children with and without exudative otitis media

Effects of tonsillectomy and adenoidectomy on the immune system

Surgical removal of the tonsils and adenoids, important immune organs, is a frequent and recurrent class of surgery, and currently, there is no consensus on the effects these surgical procedures may have on the immune system. Here, we examine individual studies on tonsillectomy, adenoidectomy, and adenotonsillectomy, discuss their postoperative humoral and cellular immune changes, and explore their effects on the incidence of related diseases. There is evidence that these three surgeries have no negative effects on humoral immunity; however, there has been contrary results. Furthermore, these procedures seem to have no significant effects on cellular immunity, although tonsil and adenoid removal can cause an increased incidence of certain illnesses, especially infectious diseases. Based on this comprehensive review, we conclude that the removal of tonsils and adenoids does not negatively affect cellular and humoral immunity. However, surgery may lead to an increased incidence of related infectious diseases. This finding may inform the surgeon's decision to perform the procedure in a clinical setting.

Persistent Nasal Obstruction: An Expression of the Pro-Inflammatory State?

Introduction: During the first years of life, the oro-pharyngeal lymphoid tissue gradually increases in size, causing in some children difficulty breathing and often leading to surgical removal of the tonsils and adenoids. The objective of the study is to assess the effects of the Mediterranean diet in children who had chronic upper airway obstruction. Material and methods: This was a prospective study pre-test/post-test comparison. Eighty-seven patients from two to eight years old were recruited. A food reeducation program based on the Mediterranean diet was applied for one year. Clinical, therapeutic, and anthropometric variables were studied. Results: The degree of nasal obstruction decreased in 95.1% of the patients. After the nutritional intervention, the number of colds with bacterial complications decreased by 80.26%; 60.9% had no bacterial complications during the year of the study. The use of antibiotics decreased by 81.94%. Symptomatic treatment decreased by 61.2%. Most patients did not require surgical intervention, and clinical evolution suggested that it would no longer be necessary. Conclusions: We can conclude by saying that the application of the traditional Mediterranean diet could be effective in the prevention and treatment of persistent nasal obstruction, limiting pharmacological and surgical intervention in many of these patients.

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

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.

Adenoids in children: Advances in immunology, diagnosis, and surgery

Adenoids are strategically located for mediating local and regional immune functions as they are exposed to antigens from both the outside air and the alimentary tract. Recurrent or chronic respiratory infections can induce histomorphological and functional changes in the adenoidal immunological barrier, sometimes making surgical treatment necessary. Our aim in this review is to summarize the crucial points about not only the immunological histopathology of adenoidal tissue, especially in patients with adenoid hypertrophy, but also the most common and useful diagnostic techniques and surgical options.