Will tonsil removal in children affect immune function?

Tonsils are one of the body's immune organs and are often considered the "first line of defense" against pathogens. However, when repeated inflammation or hypertrophy of the tonsils causes health problems, doctors may recommend surgical removal. Many parents worry: Will removing the tonsils weaken their children's immunity? This article combines medical research and clinical views to answer this question for you.

1. Immune function of tonsils

1. Physical barriers and pathogen capture

Tonsils are located on both sides of the oropharynx, which are the entrances to the respiratory and digestive tracts and can directly contact pathogens (bacteria, viruses, etc.) in the air and food. The uneven crypt structure can increase the contact area, adhere to and capture pathogens through mucus and cilia, and prevent them from penetrating deep into the respiratory or digestive tracts.

2. Generation and activation of immune cells

Tonsils are rich in immune cells such as B cells, T cells, and dendritic cells, which can recognize pathogen antigens and initiate immune responses. After antigen stimulation, germinal centers are formed in the tonsils, promoting B cells to differentiate into plasma cells, produce antibodies, and neutralize pathogens. Some lymphocytes will transform into memory cells to provide a rapid response to future invasions of the same pathogen.

3. Key role of mucosal immunity

Tonsils belong to mucosa-associated lymphoid tissue (MALT), participate in the mucosal immune system, secrete immunoglobulin A (IgA), and protect the oropharyngeal mucosa from infection.

4. Immune signaling

Tonsillar cells can release cytokines (such as interferon and interleukin) to coordinate local and systemic immune responses.

2. Relationship between the immune function of tonsils and age

Children's immune system is not yet mature, and tonsils are one of the most active immune organs. It plays an important role in the immune defense of early childhood (especially in infancy): by capturing pathogens (such as bacteria, viruses) and activating immune responses, producing antibodies and lymphocytes. Recurrent tonsillitis is common in children and may be related to the "exercise" process of the immune system. As we age, the immune function of tonsils gradually weakens.

Studies have shown that the immune system of children under the age of 3 is not fully mature, and the tonsils play a more prominent role; after the age of 3, other immune organs (such as lymph nodes, spleen, bone marrow, etc.) gradually assume the main defense tasks, and the function of the tonsils weakens accordingly. Therefore, if surgery is required, the probability of the immune function of children over 3 years old being affected is lower.

3. The actual impact of tonsillectomy on immunity

1. Short-term adjustments:

In the early weeks after surgery, some children may have an increased frequency of upper respiratory tract infections as the immune system adjusts to the absence of tonsils, but this effect is usually temporary.

2. Long-term compensation:

The human immune system has a strong compensatory ability. Even if the tonsils are removed, other lymphatic tissues (lymph nodes, etc.) will gradually take over their functions. Studies have shown that immunoglobulin levels can return to normal 3 months after surgery.

3. Individual differences:

If the child has an immunodeficiency disease or is receiving immunosuppressive treatment, tonsillectomy may increase the risk of infection, and a doctor's evaluation is required to develop an individualized plan.

When is surgery necessary? Weighing the pros and cons

Indications for surgery:

Repeated tonsil infections (≥ 4 attacks per year) or serious complications (such as nephritis, sleep apnea);

Excessively enlarged tonsils can cause breathing difficulties, swallowing problems, or developmental delays.

Benefits of surgery:

Eliminate lesions and reduce the recurrence of tonsil infection;

Improve breathing and sleep quality and promote normal development of children.

Potential risks:

In rare cases, dry throat, foreign body sensation when swallowing, or tonsil regrowth may occur after surgery.

5. Postoperative care and immune recovery suggestions

1. Improve nutrition: Eat more fruits and vegetables rich in vitamins to enhance immunity.

2. Maintain hygiene: wash your hands frequently and avoid contact with sources of infection to reduce the risk of postoperative infection.

3. Regular follow-up: Check recovery status and deal with abnormal symptoms in a timely manner.

4. Immunization: Get vaccinated as scheduled to prevent infection with specific pathogens.