Effect of tonsillectomy on humeral and cellular immunity: a systematic review of published studies from 2009 to 2019

Abstract

Background: Although tonsillectomy is the most commonly performed surgical operation for children, its postoperative effect on the immune response was a source of debate among physicians. Purpose: The aim of this systemic review was study the effect of tonsillectomy on children immune response. Data sources: PubMed, Medline, Embase and Cochrane Library. Review methods: All relevant articles published English language addressing the effect of tonsillectomy on the immune system were included. One investigators extracted data regarding: year of the study, sample size, study design, sample size, timing of analysis, studied immune factors, result and conclusion were identified. Another investigator independently reviewed data accuracy. Results: Ten articles published between from January 2009 to January 2019 in about this issue that included 404 children were reviewed. All reviewed studies showed a non-significant difference between levels of indicators of the humeral immunity (IgA, IgG, IgM, C3 and C4) pre- and postoperatively. Studies that measured these indicators only after surgery, showed a non-significant difference in their levels between patients and healthy controls. Levels of indicators of cellular immunity (CD4+ , CD3+ , CD8+ , CD19+ , CD25+ , CD16+ , CD+ 56) showed slight reduction or increase in some studies but without a significant difference compared to their levels preoperatively, postoperatively at different intervals or with healthy controls. Other studies found no changes in these indicators postoperatively. Conclusion: There was enough evidence to conclude that tonsillectomy has no negative affect on both humeral and cellular immunity of children