Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckFunctional and immunological aspects of adenoidectomy in children: clinical research experience
V. V. Dvoryanchikov (1), M. V. Drozdova (2), Yu. K. Yanov (3), A. V. Karelin (4), A. A. Karelina (5)
(1), (2), (4), (5) Saint Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation, (3) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation
UDK: УДК 616.22-006.33-089.87-053.3:577.27
DOI: https://doi.org/10.18692/1810-4800-2026-2-17-24
ABSTRACT
Abstract. Modern ideas about the role of the pharyngeal tonsil as a key element of mucosal immunity have led to a revision of approaches to its surgical treatment for hypertrophy in children. Despite the high clinical efficacy of radical adenoidectomy in eliminating nasal obstruction and associated complications, the accumulated data on possible immunological and long-term respiratory consequences of surgery require a more balanced choice of surgical tactics. Objective. To systematize current data about surgical methods of treating hypertrophy of the pharyngeal tonsil with a focus on the immunological and functional consequences of surgery, to analyze the evolution of methods from radical to partial adenoidectomy, to assess the impact of surgery on humoral and cellular immunity, and to consider the potential association of adenoidectomy with allergic diseases evolution. The article provides an analytical review of domestic and foreign studies on the evolution of surgical techniques, from radical removal of lymphoid tissue to partial adenoidectomy and other organ-preserving techniques. The article examines changes in humoral and cellular immunity after adenoidectomy, including the dynamics of immunoglobulins and T-cell subsets. The article analyzes data about possible association of adenoidectomy with an increased risk of bronchial asthma, infectious diseases, and allergies in the long term, and existing contradictions in the scientific literature are identified. Special attention is paid to the advantages of partial adenoidectomy as a method that allows to preserve the immunological function of the pharyngeal tonsil and reduce the risk of velopharyngeal insufficiency, especially in patients with congenital palate anomalies and a burdened allergic history. A clinical example of a young child with hypertrophy of the tonsils of the pharyngeal lymphatic ring, allergic rhinitis, and Eustachian tube dysfunction is presented, demonstrating the effectiveness of organ-preserving surgery using CO2-laser technology. The article emphasizes the need for a differentiated and multidisciplinary approach to the choice of surgical tactics, according to the patient’s age, immunological status, and risk factors for the development of allergic pathology. The article also justifies the feasibility of further research aimed at studying the long-term immunological consequences of partial adenoidectomy.
Publication date:
15.04.2026
Keywords:
pharyngeal tonsil hypertrophy, partial adenoidectomy, adenoidectomy, immunity, allergic diseases, children, organ-preserving surgery For citation:
Dvoryanchikov V. V., Drozdova M. V., Yanov Yu. K., Karelin A. V., Karelina A. A. Functional and immunological aspects of adenoidectomy in children: clinical research experience. Russian Otorhinolaryngology. 2026;25(2):17-24. (In Russ.) https://doi.org/10.18692/1810-4800-2026-2-17-24