الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SUMMARY ~ CONCLUSION
Human tonsi Is act as f i 1tere at the beginning of both
respiratory and digestive system.
Human tonsi Is are known to be immunologically reactive
lymphoid tissue which manifests specific antibody and Band T
cells activity in response to a variety of antigens. carrying
out the functions of humoral and cellular immunity. The
tonsils contain many cells. committed to antibody formation.
which can be shown to contain immunoglobulins of the main
classes: IgG. IgA. 19M. The palatine tonsils r e Lee.se t he i r
antibodies locally as well as the general pool. The impact of
the microbiological environment on the developing Iymphoid
t issues of the tons i 1s resul ts In one of the most common
surgical procedures in childhood. the removal of the tonsils.
Tonsillectomy has become such a popular operation. s c widely
used and so often misused. The quest i on whether the remova 1
of the tonsils might compromise the local immunologic
functions of the host or not. is the focus of long standing
controversy.
In this work. the levels of secretorey IgA in saliva were
determined in fifty patients with chronic tonsillitis. The
immunoglobulin A was estimated before and one month after the
operation. The immunoglobulin estimations were carried out by
single radial immunodiffusion technique. Seven normal
subjects estimated as a control. Our resul ts showed
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significant DROP of secretory IgA in the saliva of the
patients postoperativelY as compared either with preoperative
values or with control.
Accordingly. SIgA gives us one of the immunological
implications of tonsillectomy.
The postoperative decrease in SIgA is due to removal of
the tonsils which are regulatory lymphoid organs involved in
the maintenance of local immunity of oral cavity and pharynx.
The impairment of the local immunological defence in the
months following the operation may predispose to recurrent
pharyngeal infections.
We can conclude that estimation of SIgA may be of a
diagnostic and prognostic value serving as a guide for proper
evaluation of tonsillectomy.
Now, a more conservative attltude towards tonsillectomy
is recommended as the local defence mechanisms may
deteriorate after removal of the tonsils.
This operation should be performed only when precise
indications. based on strict clinical and laboratory data
exist. Applying this policy. besides reducing the expenses
and risks connected with tonsillectomy. might also avoid
subsequent immunological impairment.
Finally. we have to emphasize the improtance of further
inte:rgrated studies of the possible immunological
implications of tonsillectomy.