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Peer-reviewedCC BYLaryngoscope investigative otolaryngology

The Immunological Consequences of Pediatric Adenotonsillectomy: Myths, Evidence, and Unsolved Questions.

  • Barbara Verro1
  • Gaetano Ottoveggio2
  • Simona Fiumara3
  • Carmelo Saraniti1
  1. 1Unit of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND) University of Palermo Palermo Italy.
  2. 2Unit of Anesthesia Analgesia Intensive Care and Emergency, Department of Precision Medicine in Medical, Surgical and Critical Care University Hospital Policlinico Paolo Giaccone, Palermo Palermo Italy.
  3. 3Speech Therapist Private Practice Palermo Italy.
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Abstract

Tonsillectomy is one of the most common surgical procedures in pediatric populations, indicated primarily for recurrent tonsillitis and upper airway obstruction. Palatine tonsils represent lymphoepithelial structures crucial for local and systemic immune surveillance, with a key role in lymphocyte maturation and the production of immunoglobulins, particularly secretory IgA. This review summarizes the available evidence on the immunological impact of tonsillectomy, including short- and long-term studies. Data show that tonsillar removal can result in transient changes in immunoglobulin and lymphocyte levels, often associated with resolution of a chronic inflammatory state, without compromising the global immune response. Clinical studies also indicate a benefit in reducing recurrent febrile episodes, such as in PFAPA syndrome. Some evidence suggests possible long-term effects, such as an increased risk of autoimmune or periodontal diseases, especially if the intervention is performed at an early age, although the causality is not yet clear. In conclusion, tonsillectomy performed according to selective clinical criteria generally appears immunologically safe and may provide targeted therapeutic benefits under conditions of local or systemic tonsil dysfunction.

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Cite

BibTeXRIS
BibTeX
@article{verro2026immunological,
  title = {{The Immunological Consequences of Pediatric Adenotonsillectomy: Myths, Evidence, and Unsolved Questions.}},
  author = {Barbara Verro and Gaetano Ottoveggio and Simona Fiumara and Carmelo Saraniti},
  journal = {Laryngoscope investigative otolaryngology},
  year = {2026},
  month = oct,
  doi = {10.1002/lio2.70556},
  url = {https://europepmc.org/article/MED/42899024},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The Immunological Consequences of Pediatric Adenotonsillectomy: Myths, Evidence, and Unsolved Questions.
AU  - Barbara Verro
AU  - Gaetano Ottoveggio
AU  - Simona Fiumara
AU  - Carmelo Saraniti
PY  - 2026
DA  - 2026/10/19
JO  - Laryngoscope investigative otolaryngology
DO  - 10.1002/lio2.70556
UR  - https://europepmc.org/article/MED/42899024
AB  - Tonsillectomy is one of the most common surgical procedures in pediatric populations, indicated primarily for recurrent tonsillitis and upper airway obstruction. Palatine tonsils represent lymphoepithelial structures crucial for local and systemic immune surveillance, with a key role in lymphocyte maturation and the production of immunoglobulins, particularly secretory IgA. This review summarizes the available evidence on the immunological impact of tonsillectomy, including short- and long-term studies. Data show that tonsillar removal can result in transient changes in immunoglobulin and lymphocyte levels, often associated with resolution of a chronic inflammatory state, without compromising the global immune response. Clinical studies also indicate a benefit in reducing recurrent febrile episodes, such as in PFAPA syndrome. Some evidence suggests possible long-term effects, such as an increased risk of autoimmune or periodontal diseases, especially if the intervention is performed at an early age, although the causality is not yet clear. In conclusion, tonsillectomy performed according to selective clinical criteria generally appears immunologically safe and may provide targeted therapeutic benefits under conditions of local or systemic tonsil dysfunction.
SN  - 2378-8038
ER  -