Microbiological profile and immunological changes in pediatric chronic adenotonsillar hypertrophy before and after adenotonsillectomy.

Abstract

Tonsils play a crucial role in the immune systems, and infections that involve them among the most common human illnesses, particularly in children. Recurrent adenotonsillitis prevails in such age and accounts for the primary reason for visits to primary care physicians. Adenotonsillectomy represents the most regularly performed surgical operations in children. While the effects of chronic adenotonsillitis (chronic inflammatory hypertrophy) on immune systems before and after adenotonsillectomy in children are not fully understood. This study aimed to showcase the bacterial pathogens associated with chronic adenotonsillitis, and to assess the impact of adenotonsillectomy on humoral immunity in children at the time of surgery and 3 months following the procedure. The study included 35 children scheduled for adenotonsillectomy, and 35 normal children as a control group. Throat bacterial cultures, and blood samples were taken at surgery time and three months after surgery. Methicillin-resistant Staphylococcus aureus was among the most frequent pathogens. IgM, IgG, and IgA levels were significantly decreased after surgery compared to before surgery time (p < 0. 01). Significant changes were also seen when compared to the controls (p < 0.01). Prior to surgery, serum interleukin-8 (IL-8) levels were substantially greater than those following surgery and compared to controls (p < 0.01). According to our findings, adenotonsillectomy lowers long-term immune dysfunction without creating chronic immunological activation. In conclusion, while adenotonsillectomy initially lowers humoral immune responses, these levels return to normal within a few months of surgery. This indicates a transitory reduction in chronic immunological activation without long-term negative consequences on immune function.