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

  • A Yenigun (a1)

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.

Copyright

Corresponding author

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

References

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1McNeill, RA. A History of Tonsillectomy: Two Millenia of Trauma, Haemorrhage and Controversy. Ulster Med J 1960;29:5963
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;137:558–70
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;32:22–8
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;46:875–87
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;6:283–7
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;97:155–6
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;26:1021–8
8Roxburgh, CS, McMillan, DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol 2002;6:149–63
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;102:653–7
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;34:5560
11Brodsky, L, Moore, L, Stanievich, J. The role of Haemophilus influenzae in the pathogenesis of tonsillar hypertrophy in children. Laryngoscope 1988;98:1055–60
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;74:133–6
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;140:894901
14Bluestone, CD, Cantekin, EI, Beery, QC. Certain effects of adenoidectomy of Eustachian tube ventilatory function. Laryngoscope 1975;85:113–27
15Rosenfeld, RM, Green, RP. Tonsillectomy and adenoidectomy: changing trends. Ann Otol Rhinol Laryngol 1990;99:187–91
16Parker, NP, Walner, DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2011;75:282–5
17Discolo, CM, Darrow, DH, Koltai, PJ. Infectious indications for tonsillectomy. Pediatr Clin North Am 2003;50:445–58
18Vieira, F, Allen, SM, Stocks, RM, Thompson, JW. Deep neck infection. Otolaryngol Clin North Am 2008;41:459–83
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;2:656–62
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;24:451–4
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;102:653–7
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;101:747–52
23Walsh, SR, Cook, EJ, Goulder, F, Justin, TA, Keeling, NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181–4
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;97:993–6
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;154:9951002
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;137:425–8
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;34:155–9
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;34:6974
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;36:491
30Biaaas, M, Taran, K, Gryszkiewicz, M, Modzelewski, B. Evaluation of neutrophil-lymphocyte ratio usefulness in the diagnosis of appendicitis [in Polish]. Wiad Lek 2006;59:601–6

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