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[This article belongs to Volume - 26, Issue - 03]

Tonsillectomy (Removal of Extramedullary Lymphoid Tissue) and it's Associated with Parkinson Disease: A meta-analysis

The unique position of the tonsils at the gateways of both the respiratory and gastrointestinal tract suggested a dual role of its lymphoid tissue. Besides, alpha-synuclein (a pro-inflammation mediator) accumulates decades before the onset of Parkinson's disease (PD) and may play a role in PD pathophysiology. This is the first meta-analysis to assess the relationship between tonsillectomy and PD. This meta-analysis aimed to assess the effects of tonsillectomy on PD incidence. The PubMed, Cochrane library, and the first hundred articles in Google Scholar databases were systematically searched for relevant articles. We include prospective and retrospective cohorts and case-control studies published in the English language and assessing the relationship between tonsillectomy and Parkinson's disease in adults. All articles from the first published up to February 2024 were approached. The keywords used were Parkinson's disease, tonsillitis, Parkinsonism, tonsillectomy, gut lymphoid tissue, and movement disorders with protean "AND" or "OR". No restriction to the time of publication was applied to the searching engine. Out of the 194 references found, five cohorts from two studies fulfilled the inclusion and exclusion criteria. The studies included 8322391 patients and 50405 events. No significant heterogeneity observed (I2=10%, P-value, 0.35). No association was observed between Parkinson's disease and tonsillectomy, odd ratio, 1.00, 95% CI, 0.92-1.09, and P-value, 0.98. The small number of the included studies (only from Europe) limited the above results. No association was found between tonsillectomy and PD, further research evaluating the tonsil microbiome on systemic diseases are recommended.