The Effect of Tonsillectomy on the Salivary Immune Factors: A Systematic Review and Meta-Analysis

In their critical position at the entrance of the aerodigestive tract, the palatine tonsils play an important role in sampling antigens directly from the epithelial surfaces. The number of bacteria shed into the saliva reaches 100 billion per day in healthy individuals [1]. A healthy environment is maintained in the oral cavity by adequate salivary flow to clear the microbes and by the various local immune factors, in which the tonsils are believed to play an important role [2]. The architecture of the tonsils resembles that of a lymph node in having antigen-presenting cells, T cells, B cells [3]. The palatine tonsils produce antibodies locally and distally through their migrating B cells. They are quite active in the pediatric age group when their size is most prominent knowing that the size is directly proportional to the number of tonsillar B and T cells [4].