The role of inflammation markers in predicting the prognosis of Bell's palsy

Year 2019, Volume: 5 Issue: 4, 629 - 635, 04.07.2019

Bülent Ulusoy Kazım Bozdemir Hayati Kale Mehmet Hakan Korkmaz

https://doi.org/10.18621/eurj.404778

Cited By: 3

Abstract

Objectives: This study aimed to
investigate the relationship between the neutrophil-to-lymphocyte
ratio (NLR) and the platelet-to-lymphocyte
ratio (PLR) and Bell’s palsy in addition to the usability of these markers to
predict prognosis.

Methods: In this prospective study, the patient group included 24 patients that were
diagnosed with Bell’s palsy and 29 healthy volunteers that had similar
characteristics to them regarding age and gender with patient group as the
control group. The temporal gadolinium-enhanced magnetic resonance imaging
(TGd-MRI) was performed to all patients. The complete blood count was also obtained
from both the patient and the control groups, and these two groups were
compared for NLR and PLR, mean platelet volume (MPV), platelet distribution
width (PDW), and platelet count. The relationship between these markers and
Bell’s paralysis prognosis was also investigated.

Results: The patient and control groups were similar in age and gender (p > 0.05). NLR was significantly
higher in the patient group compared with the control group (p = 0.016). There was no correlation
between the NLR value and the prognosis of Bell’s Palsy. The PDW and white
blood cell count (WBC) were significantly higher in the patient group than the
control group (p = 0.023 and p = 0.012, respectively). A comparison
of the recovered and unrecovered patients revealed that the PDW value was
significantly higher and the platelet count was lower in the recovered patients
than the unrecovered patients (p = 0.009 and p = 0.003 respectively). The MPV value was higher in the recovered
patients, though not statistically significant (p = 0.063). Based on the cut-off values determined in the receiver
operator characteristic (ROC) curve analysis, a comparison of the recovered and
unrecovered patients reveals that the likelihood of not healing was significantly
higher in those that had normal PDW values (p
= 0.036). 

Keywords

Bell palsy, inflammation, mean platelet volume, prognosis, platelet activation, ROC curve, neutrophil

References

• [1] Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol 2008; 265:743-52.
• [2] Greco A, Gallo A, Fusconi M, Marinelli C, Macri GF, de Vincentiis M. Bell's palsy and autoimmunity. Autoimmun Rev 2012;12:323-8.
• [3] Bucak A, Ulu S, Oruc S, Yucedag F, Tekin MS, Karakaya F, et al. Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy. Laryngoscope 2014;124:1678-81.
• [4] Kum RO, Yurtsever Kum N, Ozcan M, Yilmaz YF, Gungor V, Unal A, et al. Elevated neutrophil-to-lymphocyte ratio in Bell's palsy and its correlation with facial nerve enhancement on MRI. Otolaryngol Head Neck Surg 2015;152:130-5.
• [5] Wasano K, Kawasaki T, Yamamoto S, Tomisato S, Shinden S, Ishikawa T, et al. Pretreatment hematologic findings as novel predictive markers for facial palsy prognosis. Otolaryngol Head Neck Surg 2016;155:581-7.
• [6] Tekgul H, Polat M, Serdaroğlu G, Ikizoğlu T, Yalaz M, Kutukculer N, et al. Lymphocyte subsets in Bell's palsy: immune pathogenesis and outcome prediction. Pediatr Neurol 2004;31:258-60.
• [7] Yilmaz M, Tarakcioglu M, Bayazit N, Bayazit YA, Namiduru M, Kanlikama M. Serum cytokine levels in Bell's palsy. J Neurol Sci 2002;15:69-72.
• [8] Küçük E, Kocayiğit I, Günel C, Düzenli H. Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years. World J Emerg Med 2016;7:165-72.
• [9] Özler GS, Günak G. Neutrophil-lymphocyte ratio: a new predictive and prognostic factor in patients with Bell palsy. J Craniofac Surg 2014;25:944-5.
• [10] Atan D, Ikinciogullari A, Koseoglu S, Ozcan KM, Cetin MA, Ensari S, et al. New predictive parameters of Bell's palsy: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Balkan Med J 2015;32:167-70.
• [11] Sahin C, Varım C. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume and red cell distribution width measures in Bells palsy. Open Access Maced J Med Sci 2017;15:14-8.
• [12] Eryilmaz A, Basal Y, Tosun A, Kurt Omurlu I, Basak S. The neutrophil to lymphocyte ratios of our pediatric patients with Bell's palsy. Int J Pediatr Otorhinolaryngol 2015;79:2374-7.
• [13] Wasano K, Ishikawa T, Kawasaki T, Yamamoto S, Tomisato S, Shinden S et al. Novel pre-therapeutic scoring system using patient and haematological data to predict facial palsy prognosis. Clin Otolaryngol 2017;42:1224-8.
• [14] Chen Y, Xiao Y, Lin Z, Xiao X, He C, Bihl JC et al. The role of circulating platelets microparticles and platelet parameters in acute ischemic stroke patients. J Stroke Cerebrovasc Dis 2015;24:2313-20.
• [15] Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res 1983;32:443-60.
• [16] Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010;14:28-32.
• [17] Sevuk U, Bahadir MV, Altindag R, Baysal E, Yaylak B, Ay N, et al. Value of serial platelet indices measurements for the prediction of pulmonary embolism in patients with deep venous thrombosis. Ther Clin Risk Manag 2015;11:1243-9.
• [18] Özler GS, Okuyucu S. Increased mean platelet volume in patients with Bell’s palsy. Int Adv Otol 2014;10: 281-3.