Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T11:07:29.492Z Has data issue: false hasContentIssue false
  • English
  • Français

The efficacy of tonsillectomy in chronic tonsillitis patients as demonstrated by the neutrophil-to-lymphocyte ratio

Published online by Cambridge University Press:  20 March 2015

A Yenigun
A Yenigun*
Affiliation:
Konya Hospital, Otorhinolaryngology Clinic, Konya, Turkey
*
Address for correspondence: Dr A Yenigun, Otorhinolaryngology Clinic, Konya Hospital, Şemsi Tebrizi Mah. Şerafettin Cd. No: 95, 42080 Karatay-Konya, Turkey Fax: +90 332 350 3777 E-mail: alperyenigun@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Adenoidectomy and tonsillectomy are the oldest surgical procedures. The neutrophil-to-lymphocyte ratio is an inflammatory marker. This study aimed to investigate neutrophil-to-lymphocyte ratios in chronic tonsillitis patients and to determine whether this ratio reflects the pre- and post-operative inflammatory status in these patients.

Methods:

Patients and healthy individuals were assigned to four groups: the adenoid hypertrophy, adenotonsillar hypertrophy, chronic tonsillitis and control groups. The neutrophil-to-lymphocyte ratio was calculated for each patient before surgery and one month post-surgery. Pre- and post-operative white blood cell, neutrophil and lymphocyte counts and neutrophil-to-lymphocyte ratios were compared both within and between groups.

Results:

Pre- and post-operative neutrophil-to-lymphocyte ratios were significantly higher in the chronic tonsillitis group than in the adenoid hypertrophy and adenotonsillar hypertrophy groups (p < 0.01 and p < 0.05, respectively). In the chronic tonsillitis group, post-operative neutrophil-to-lymphocyte ratios were significantly lower than pre-operative ratios (p = 0.045). The pre-operative neutrophil-to-lymphocyte ratio was significantly higher in the chronic tonsillitis group than in the adenoid hypertrophy, adenotonsillar hypertrophy and control groups (p = 0.000). In contrast, there was no significant difference in post-operative neutrophil-to-lymphocyte ratios among all groups (p = 0.584).

Conclusion:

The neutrophil-to-lymphocyte ratio measurement can be used in chronic tonsillitis patients as an effective auxiliary method for determining the necessity and timing of tonsillectomy and post-operative follow up, thereby helping prevent complications due to delayed or inadequate treatment.

Keywords

NeutrophilsLymphocytesAdenoidectomyTonsillectomyChronic DiseaseTonsillitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 386 - 391
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1McNeill, RA. A History of Tonsillectomy: Two Millenia of Trauma, Haemorrhage and Controversy. Ulster Med J 1960;29:59–63Google Scholar
2Alexiou, VG, Salazar-Salvia, MS, Jervis, PN, Falagas, ME. Modern technology-assisted vs conventional tonsillectomy: a meta-analysis of randomized controlled trials. Arch Otolaryngol Head Neck Surg 2011;137:558–70Google Scholar
3Fogar, P, Sperti, C, Basso, D, Sanzari, MC, Greco, E, Davoli, C et al. Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas 2006;32:22–8Google Scholar
4Wichmann, MW, Meyer, G, Adam, M, Höchtlen-Vollmar, W, Angele, MK, Schalhorn, A et al. Detrimental immunologic effects of preoperative chemoradiotherapy in advanced rectal cancer. Dis Colon Rectum 2003;46:875–87Google Scholar
5Kusumanto, YH, Dam, WA, Hospers, GA, Meijer, C, Mulder, NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 2003;6:283–7CrossRefGoogle ScholarPubMed
6Avanzas, P, Quiles, J, Lopez de Sa, E, Sanchez, A, Rubio, R, Garcia, E et al. Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol 2004;97:155–6Google Scholar
7Fock, RA, Blatt, SL, Beutler, B, Pereira, J, Tsujita, M, de Barros, FE et al. Study of lymphocyte subpopulations in bone marrow in a model of protein-energy malnutrition. Nutrition 2010;26:1021–8Google Scholar
8Roxburgh, CS, McMillan, DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol 2002;6:149–63Google Scholar
9Tamhane, UU, Aneja, S, Montgomery, D, Rogers, EK, Eagle, KA, Gurm, HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653–7CrossRefGoogle ScholarPubMed
10Halazun, KJ, Aldoori, A, Malik, HZ, Al-Mukhtar, A, Prasad, KR, Toogood, GJ et al. Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 2008;34:55–60Google Scholar
11Brodsky, L, Moore, L, Stanievich, J. The role of Haemophilus influenzae in the pathogenesis of tonsillar hypertrophy in children. Laryngoscope 1988;98:1055–60Google Scholar
12Faramarzi, A, Kadivar, MR, Heydari, ST, Tavasoli, M. Assessment of the consensus about tonsillectomy and/or adenoidectomy among pediatricians and otolaryngologists. Int J Pediatr Otorhinolaryngol 2010;74:133–6Google Scholar
13Erickson, BK, Larson, DR, St Sauver, JL, Meverden, RA, Orvidas, LJ. Changes in incidence and indications of tonsillectomy and adenotonsillectomy, 1970–2005. Otolaryngol Head Neck Surg 2009;140:894–901Google Scholar
14Bluestone, CD, Cantekin, EI, Beery, QC. Certain effects of adenoidectomy of Eustachian tube ventilatory function. Laryngoscope 1975;85:113–27Google Scholar
15Rosenfeld, RM, Green, RP. Tonsillectomy and adenoidectomy: changing trends. Ann Otol Rhinol Laryngol 1990;99:187–91Google Scholar
16Parker, NP, Walner, DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2011;75:282–5Google Scholar
17Discolo, CM, Darrow, DH, Koltai, PJ. Infectious indications for tonsillectomy. Pediatr Clin North Am 2003;50:445–58Google Scholar
18Vieira, F, Allen, SM, Stocks, RM, Thompson, JW. Deep neck infection. Otolaryngol Clin North Am 2008;41:459–83Google Scholar
19Arruda-Olson, AM, Reeder, GS, Bell, MR, Weston, SA, Roger, VL. Neutrophilia predicts death and heart failure after myocardial infarction: A community-based study. Circ Cardiovasc Qual Outcomes 2009;2:656–62Google Scholar
20Rudiger, A, Burckhardt, OA, Harpes, P, Muller, SA, Follath, F. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 2006;24:451–4Google Scholar
21Tamhane, UU, Aneja, S, Montgomery, D, Rogers, EK, Eagle, KA, Gurm, HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653–7Google Scholar
22Nunez, J, Nunez, E, Bodi, V, Sanchis, J, Miñana, G, Mainar, L et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008;101:747–52Google Scholar
23Walsh, SR, Cook, EJ, Goulder, F, Justin, TA, Keeling, NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181–4Google Scholar
24Duffy, BK, Gurm, HS, Rajagopal, V, Gupta, R, Ellis, SG, Bhatt, DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993–6Google Scholar
25Gibson, PH, Croal, BL, Cuthbertson, BH, Small, GR, Ifezulike, AI, Gibson, G et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995–1002Google Scholar
26Sarraf, KM, Belcher, E, Raevsky, E, Nicholson, AG, Goldstraw, P, Lim, E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg 2009;137:425–8Google Scholar
27Turkmen, K, Guney, I, Yerlikaya, FH, Tonbul, HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail 2012;34:155–9Google Scholar
28Kuyumcu, ME, Yesil, Y, Ozturk, ZA, Kizilarslanoğlu, C, Etgül, S, Halil, M et al. The evaluation of neutrophil-lymphocyte ratio in Alzheimer's disease. Dement Geriatr Cogn Disord 2012;34:69–74CrossRefGoogle ScholarPubMed
29Torun, S, Tunc, BD, Suvak, B, Yildiz, H, Tas, A, Sayilir, A et al. Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: a promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012;36:491Google Scholar
30Biaaas, M, Taran, K, Gryszkiewicz, M, Modzelewski, B. Evaluation of neutrophil-lymphocyte ratio usefulness in the diagnosis of appendicitis [in Polish]. Wiad Lek 2006;59:601–6Google Scholar