Klinik Araştırma
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Evaluating Inflammatory Markers in Sudden Sensorineural Hearing Loss: The Neutrophil-To-Lymphocyte Ratio, The Systemic Immune Inflammation Index, and The Pan Immune Inflammation Value as Prognostic Tools

Yıl 2025, Cilt: 47 Sayı: 3, 386 - 394, 02.05.2025
https://doi.org/10.20515/otd.1612452

Öz

This research sought to explore the association between sudden sensorineural hearing loss and inflammation by analyzing key inflammatory indicators, such as the neutrophil-to-lymphocyte ratio, the systemic immune inflammation index , and the pan-immune-inflammation value .This retrospective study was conducted at a tertiary medical center's otolaryngology department between 2016 and 2021, involving sudden sensorineural hearing loss patients diagnosed and treated during the specified period. Two hundred sudden sensorineural hearing loss patients and 200 healthy controls were included. Inflammatory markers were calculated from complete blood count data. Audiological evaluations categorized patients based on hearing loss severity. Patients with sudden sensorineural hearing loss demonstrated significantly elevated levels of inflammatory markers compared to the control group: NLR: 3.43 ± 2.99 vs. 2.10 ± 1.28, p < 0.001; SII: 953.72 ± 855.02 vs. 561.74 ± 355.60, p < 0.001; and PIV: 523.84 ± 455.48 vs. 342.48 ± 245.47, p < 0.001. ROC analysis revealed superior diagnostic performance for the systemic immune inflammation index, and the pan-immune-inflammation value, with AUC values of 0.693 and 0.648, respectively, compared to NLR (AUC = 0.692). This study provides novel insights into the relationship between inflammation and sudden sensorineural hearing loss. Elevated neutrophil-to-lymphocyte ratio, the systemic immune inflammation index, and the pan-immune-inflammation value levels in sudden sensorineural hearing loss patients suggest their potential as valuable indicators for understanding the etiology and predicting outcomes of sudden sensorineural hearing loss . The study underscores the need for further research to validate these findings and explore the underlying mechanisms connecting inflammation to sudden sensorineural hearing loss.

Etik Beyan

This study adhered to the Declaration of Helsinki's highest ethical standards and principles. Informed consent was secured from all participants, ensuring anonymity and confidentiality. Izmir Bakıircay University Local Ethics Committee approved (approved number : 24082023/1141/1121; No 1141, Research No 1121 at 24.08.2023) this study. There are no conflicts of interest, and the manuscript respects participant privacy and aligns with relevant ethical guidelines.

Destekleyen Kurum

The authors declared that this study has received no financial support.

Kaynakça

  • 1. Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019;161(1_suppl):S1-S45.
  • 2. Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013;34(9):1586-1589.
  • 3. Cvorović L, Deric D, Probst R, Hegemann S. Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2008;29(4):464-469.
  • 4. VAN DISHOECK HA, BIERMAN TA. Sudden perceptive deafness and viral infection; report of the first one hundred patients. Ann Otol Rhinol Laryngol. 1957;66(4):963-980.
  • 5. Veldman JE. Cochlear and retrocochlear immune-mediated inner ear disorders. Pathogenetic mechanisms and diagnostic tools. Ann Otol Rhinol Laryngol. 1986;95(5 Pt 1):535-540.
  • 6. Aliyeva A, Han JS, Kim Y, Lim JH, Seo JH, Park SN. Vitamin D Deficiency as a Risk Factor of Tinnitus: An Epidemiological Study. Ann Otol Rhinol Laryngol. 2024;133(7):647-653.
  • 7. Sari, E., Tokat, T., Aliyeva, A., et.al. Assessment of vitamin D levels in patients with sudden sensorineural hearing loss. Annals of Medical Research.2023. 30(5), 538–544. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/4422
  • 8. Chen HC, Chung CH, Wang CH, et al. Increased risk of sudden sensorineural hearing loss in patients with hepatitis virus infection. PLoS One. 2017;12(4):e0175266. Published 2017 Apr 6.
  • 9. Kikidis D, Nikolopoulos TP, Kampessis G, Stamatiou G, Chrysovergis A. Sudden sensorineural hearing loss: subclinical viral and toxoplasmosis infections as aetiology and how they alter the clinical course. ORL J Otorhinolaryngol Relat Spec. 2011;73(2):110-115.
  • 10. Aliyeva A, Edizer DT. Efficacy of intratympanic steroid therapy for severe and profound sudden sensorineural hearing loss. Am J Otolaryngol. Published online December 10, 2023.
  • 11. Tamhane 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(6):653-657.
  • 12. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381-75388. Published 2017 Jun 29.
  • 13. Fucà G, Beninato T, Bini M, et al. The Pan-Immune-Inflammation Value in Patients with Metastatic Melanoma Receiving First-Line Therapy. Target Oncol. 2021;16(4):529-536.
  • 14. American Speech-Language-Hearing Association. Degree of Hearing Loss. https://www.asha.org/public/hearing/degree-of-hearing-loss/
  • 15. Aliyeva A, Edizer DT. Efficacy of intratympanic steroid therapy for severe and profound sudden sensorineural hearing loss. Am J Otolaryngol. 2024;45(2):104170.
  • 16. Doo JG, Kim D, Kim Y, Yoo MC, Kim SS, Ryu J, Yeo SG. Biomarkers Suggesting Favorable Prognostic Outcomes in Sudden Sensorineural Hearing Loss. International Journal of Molecular Sciences. 2020; 21(19):7248.
  • 17. Frosolini A, Franz L, Daloiso A, Lovato A, de Filippis C, Marioni G. Digging into the Role of Inflammatory Biomarkers in Sudden Sensorineural Hearing Loss Diagnosis and Prognosis: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2022;58(7):963. Published 2022 Jul 20.
  • 18. Masuda M, Kanzaki S, Minami S, et al. Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2012;33(7):1142-1150.
  • 19. Göde S, Turhal G, Kaya İ, Mavili Hİ, Kirazlı T. Evaluation of Procalcitonin and hs-CRP Levels in Sudden Sensorineural Hearing Loss. J Int Adv Otol. 2018;14(1):44-47.
  • 20. Chen TM, Lin CC, Huang PT, Wen CF. Neutrophil-to-lymphocyte ratio associated with mortality in early hepatocellular carcinoma patients after radiofrequency ablation. J Gastroenterol Hepatol. 2012;27(3):553-561.
  • 21. Guasti L, Dentali F, Castiglioni L, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost. 2011;106(4):591-599.
  • 22. Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am J Emerg Med. 2020;38(3):641-647.
  • 23. Białas M, Taran K, Gryszkiewicz M, Modzelewski B. Wartość wskaźnika neutrofilowo-limfocytarnego w diagnostyce zapalenia wyrostka robaczkowego [Evaluation of neutrophil-lymphocyte ratio usefulness in the diagnosis of appendicitis]. Wiad Lek. 2006;59(9-10):601-606.
  • 24. Ulu S, Ulu MS, Bucak A, Ahsen A, Yucedag F, Aycicek A. Neutrophil-to-lymphocyte ratio as a new, quick, and reliable indicator for predicting diagnosis and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2013;34(8):1400-1404.
  • 25. Zhang Y, Lin S, Yang X, Wang R, Luo L. Prognostic value of pretreatment systemic immune-inflammation index in patients with gastrointestinal cancers. J Cell Physiol. 2019;234(5):5555-5563.

Ani Sensörinöral İşitme Kaybında İnflamatuar Belirteçlerin Değerlendirilmesi: Nötrofil-Lenfosit Oranı, Sistemik İmmün İnflamasyon İndeksi ve Pan İmmün İnflamasyon Değerinin Prognostik Rolü

Yıl 2025, Cilt: 47 Sayı: 3, 386 - 394, 02.05.2025
https://doi.org/10.20515/otd.1612452

Öz

Bu araştırma, nötrofil lenfosit oranını , sistemik immün-inflamasyon indeksi ve panimmun inflamasyon değeri gibi temel enflamatuar göstergeleri analiz ederek ani işitme kaybı ve enflamasyon arasındaki ilişkiyi araştırmayı amaçlamıştır.Bu retrospektif çalışma, 2016-2021 yılları arasında üçüncü basamak bir tıp merkezinin kulak burun boğaz bölümünde, belirtilen dönemde tanı konulan ve tedavi edilen ani işitme kaybı hastalarını içerecek şekilde yürütülmüştür. 200 ani işitme kaybı tanılı hasta ve 200 sağlıklı kontrol dahil edilmiştir. Enflamatuvar belirteçler tam kan sayımı verilerinden hesaplanmıştır. Odyolojik değerlendirmeler hastaları işitme kaybı şiddetine göre kategorize edilmiştir. Ani işitme kaybı hastalar kontrol grubuna kıyasla anlamlı derecede yüksek enflamatuar belirteç seviyeleri göstermiştir: NLR: 3.43 ± 2.99 vs. 2.10 ± 1.28, p < 0.001; SII: 953.72 ± 855.02 vs. 561.74 ± 355.60, p < 0.001; ve PIV: 523.84 ± 455.48 vs. 342.48 ± 245.47, p < 0.001. ROC analizi, NLR (AUC = 0,692) ile karşılaştırıldığında sırasıyla 0,693 ve 0,648 AUC değerleri ile sistemik immün-inflamasyon indeksi ve panimmun inflamasyon değeri için üstün tanısal performans ortaya koymuştur.Bu çalışma enflamasyon ve ani işitme kaybı arasındaki ilişkiye dair yeni bilgiler sunmaktadır. Ani işitme kaybı hastalarında yüksek nötrofil lenfosit oranını sistemik immün-inflamasyon indeksi ve panimmun inflamasyon değeri düzeyleri, ani işitme kaybının etiyolojisini anlamak ve sonuçlarını öngörmek için değerli göstergeler olarak potansiyellerini göstermektedir. Çalışma, bu bulguları doğrulamak ve enflamasyonu ani işitme kaybına bağlayan altta yatan mekanizmaları keşfetmek için daha fazla araştırma yapılması gerektiğinin altını çizmektedir.

Kaynakça

  • 1. Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019;161(1_suppl):S1-S45.
  • 2. Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013;34(9):1586-1589.
  • 3. Cvorović L, Deric D, Probst R, Hegemann S. Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2008;29(4):464-469.
  • 4. VAN DISHOECK HA, BIERMAN TA. Sudden perceptive deafness and viral infection; report of the first one hundred patients. Ann Otol Rhinol Laryngol. 1957;66(4):963-980.
  • 5. Veldman JE. Cochlear and retrocochlear immune-mediated inner ear disorders. Pathogenetic mechanisms and diagnostic tools. Ann Otol Rhinol Laryngol. 1986;95(5 Pt 1):535-540.
  • 6. Aliyeva A, Han JS, Kim Y, Lim JH, Seo JH, Park SN. Vitamin D Deficiency as a Risk Factor of Tinnitus: An Epidemiological Study. Ann Otol Rhinol Laryngol. 2024;133(7):647-653.
  • 7. Sari, E., Tokat, T., Aliyeva, A., et.al. Assessment of vitamin D levels in patients with sudden sensorineural hearing loss. Annals of Medical Research.2023. 30(5), 538–544. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/4422
  • 8. Chen HC, Chung CH, Wang CH, et al. Increased risk of sudden sensorineural hearing loss in patients with hepatitis virus infection. PLoS One. 2017;12(4):e0175266. Published 2017 Apr 6.
  • 9. Kikidis D, Nikolopoulos TP, Kampessis G, Stamatiou G, Chrysovergis A. Sudden sensorineural hearing loss: subclinical viral and toxoplasmosis infections as aetiology and how they alter the clinical course. ORL J Otorhinolaryngol Relat Spec. 2011;73(2):110-115.
  • 10. Aliyeva A, Edizer DT. Efficacy of intratympanic steroid therapy for severe and profound sudden sensorineural hearing loss. Am J Otolaryngol. Published online December 10, 2023.
  • 11. Tamhane 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(6):653-657.
  • 12. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381-75388. Published 2017 Jun 29.
  • 13. Fucà G, Beninato T, Bini M, et al. The Pan-Immune-Inflammation Value in Patients with Metastatic Melanoma Receiving First-Line Therapy. Target Oncol. 2021;16(4):529-536.
  • 14. American Speech-Language-Hearing Association. Degree of Hearing Loss. https://www.asha.org/public/hearing/degree-of-hearing-loss/
  • 15. Aliyeva A, Edizer DT. Efficacy of intratympanic steroid therapy for severe and profound sudden sensorineural hearing loss. Am J Otolaryngol. 2024;45(2):104170.
  • 16. Doo JG, Kim D, Kim Y, Yoo MC, Kim SS, Ryu J, Yeo SG. Biomarkers Suggesting Favorable Prognostic Outcomes in Sudden Sensorineural Hearing Loss. International Journal of Molecular Sciences. 2020; 21(19):7248.
  • 17. Frosolini A, Franz L, Daloiso A, Lovato A, de Filippis C, Marioni G. Digging into the Role of Inflammatory Biomarkers in Sudden Sensorineural Hearing Loss Diagnosis and Prognosis: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2022;58(7):963. Published 2022 Jul 20.
  • 18. Masuda M, Kanzaki S, Minami S, et al. Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2012;33(7):1142-1150.
  • 19. Göde S, Turhal G, Kaya İ, Mavili Hİ, Kirazlı T. Evaluation of Procalcitonin and hs-CRP Levels in Sudden Sensorineural Hearing Loss. J Int Adv Otol. 2018;14(1):44-47.
  • 20. Chen TM, Lin CC, Huang PT, Wen CF. Neutrophil-to-lymphocyte ratio associated with mortality in early hepatocellular carcinoma patients after radiofrequency ablation. J Gastroenterol Hepatol. 2012;27(3):553-561.
  • 21. Guasti L, Dentali F, Castiglioni L, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost. 2011;106(4):591-599.
  • 22. Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am J Emerg Med. 2020;38(3):641-647.
  • 23. Białas M, Taran K, Gryszkiewicz M, Modzelewski B. Wartość wskaźnika neutrofilowo-limfocytarnego w diagnostyce zapalenia wyrostka robaczkowego [Evaluation of neutrophil-lymphocyte ratio usefulness in the diagnosis of appendicitis]. Wiad Lek. 2006;59(9-10):601-606.
  • 24. Ulu S, Ulu MS, Bucak A, Ahsen A, Yucedag F, Aycicek A. Neutrophil-to-lymphocyte ratio as a new, quick, and reliable indicator for predicting diagnosis and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2013;34(8):1400-1404.
  • 25. Zhang Y, Lin S, Yang X, Wang R, Luo L. Prognostic value of pretreatment systemic immune-inflammation index in patients with gastrointestinal cancers. J Cell Physiol. 2019;234(5):5555-5563.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kulak Burun Boğaz
Bölüm Klinik Araştırma
Yazarlar

Sevinç Hepkarşı 0000-0001-6608-4508

Aynur Aliyeva 0000-0001-9398-4261

Gülce Kirazlı 0000-0001-7108-9987

Tayfun Kirazlı 0000-0002-5284-8842

Gönderilme Tarihi 3 Ocak 2025
Kabul Tarihi 14 Mart 2025
Yayımlanma Tarihi 2 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 3

Kaynak Göster

Vancouver Hepkarşı S, Aliyeva A, Kirazlı G, Kirazlı T. Evaluating Inflammatory Markers in Sudden Sensorineural Hearing Loss: The Neutrophil-To-Lymphocyte Ratio, The Systemic Immune Inflammation Index, and The Pan Immune Inflammation Value as Prognostic Tools. Osmangazi Tıp Dergisi. 2025;47(3):386-94.


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