Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of idiopathic sudden sensorineural hearing loss

Abstract

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The Prognostic Value of Circulating Inflammatory Cell Counts in Sudden Sensorineural Hearing Loss and the Effect of Cardiovascular Risk Factors

“…In this meta-analysis, they concluded that NLR is higher in patients who do not recover, and that NLR can be used as both diagnostic and prognostic biomarker for SSNHL. In the meta-analysis of Cao et al, 16 they reported that NLR, PLR, N, and L values were strongly associated with SSNHL, similar to Chen et al 7 In most of the studies included in both meta-analyzes, [18][19][20][21][22] patients with SSNHL carrying CVR factors such as HT, DM, and HL were accepted as an exclusion criterion, and the effects of inflammatory conditions caused by these diseases, which have been discussed to have similar pathogenesis, on NLR, PLR, N, and L values have not been investigated in patients with SSNHL. In our study, similar to the literature, we found that patients with SSNHL (group 1) had significantly higher N and NLR values than healthy controls (group 4; P ¼ .018, P ¼ .006), but those carrying CVR in addition to SSNHL (group 2) had lower N and NLR values than patients with isolated SSNHL (group 1; P ¼ .300, P ¼ .604), and we found that N values were very close to each other, especially in groups 2 and 3 (5.24 + 1.802, 5.24 + 1.845).…”

“…This abnormal N and NLR elevation in group 1 may be due to psychological and physical stress in patients with SSNHL, as mentioned by Masuda et al 23 Many authors have shown that comorbidities such as HT, DM, or HL have a negative effect on the prognosis of SSNHL, 10-14 but according to our findings, N and NLR values were not higher in group 2 than that of group 1 or 3, which was unexpected. However, if NLR elevation was strongly associated with poor prognosis in SSNHL as stated by many investigators, 7,16,[18][19][20][21][22] the highest NLR values would be expected to be in group 2 in our study. Ö zler 19 found that NLR values were higher in SSNHL patients than in the control group, though the author emphasized that the highest values were determined in patients with the most severe hearing loss the author did not show the same correlation of NLR with moderate or mild hearing loss.…”

“…Various hypotheses have been proposed for the formation of SSNHL based on infectious, vascular, traumatic, autoimmune, and metabolic disorders. 6,7 The inner ear is an ''end organ'' without collateral circulation and its blood supply is mainly provided by the labyrinthine artery. Hair cells in the cochlea consume large amounts of oxygen and are hypersensitive to hypoxia, so a decrease in blood flow is thought to result in SSNHL.…”

“…Nowadays, these inflammatory markers and the values obtained from the ratios of these markers such as NLR and PLR have been the subject of many studies as indicators of systemic inflammation. 6,7,16,17 Among these inflammatory biomarkers, especially NLR achieved large attention since it represents a combination of circulating neutrophil and lymphocyte counts. Chen et al 7 reported that NLR or PLR acted as a comprehensive indicator of 2 complementary immune pathways and NLR was significantly higher in patients with SSNHL than healthy controls.…”

“…6,7,16,17 Among these inflammatory biomarkers, especially NLR achieved large attention since it represents a combination of circulating neutrophil and lymphocyte counts. Chen et al 7 reported that NLR or PLR acted as a comprehensive indicator of 2 complementary immune pathways and NLR was significantly higher in patients with SSNHL than healthy controls. In this meta-analysis, they concluded that NLR is higher in patients who do not recover, and that NLR can be used as both diagnostic and prognostic biomarker for SSNHL.…”