Tonsillotomi hasta seçiminde nötrofil-lenfosit oranı, trombosit-lenfosit oranı ve MPV inflamasyon belirteci olarak kullanılabilir mi?

Abstract

Objective: The aim of this study was to investigate whether mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) can be used as inflammation markers in selection of pediatric patients, who were planned to undergo tonsillotomy for sleep apnea, or not.
Methods: The tonsillotomy group consisted of pediatric patients who had undergone tonsillotomy for sleep apnea between 2013–2015 years. The control group consisted of children who had presented to the Well-Child Outpatient Clinics. The patient charts were reviewed retrospectively. MPV, NLR and PLR values were recorded and analyzed.
Results: In the tonsillotomy group, there were 23 patients whereas the control group consisted of 31 healthy children. The median age was 5 in the tonsillotomy group and 6 in the control group. MPV, NLR and PLR values did not have statistically significant differences between the tonsillectomy and control groups (p=0.838, p=0.314 and p=0.896, respectively).
Conclusion: MPV, NLR and PLR values are not inflammation markers that can be used in selection of patients to undergo tonsillotomy for sleep apnea.

Keywords

• Tonsillotomi,tonsil hipertrofisi,uyku apnesi,ortalama trombosit hacmi,Tonsillotomy,tonsillar hypertrophy,sleep apnea,mean platelet volume

Kaynakça

1. 1. Wang H, Fu Y, Feng Y, Guan J, Yin S. Tonsillectomy versus tonsillotomy for sleep-disordered breathing in children: a meta-analysis. PLoS One 2015;10(3):e0121500.
2. 2. Bhattacharyya N, Kepnes LJ. Revisits and postoperative hemorrhage after adult tonsillectomy. Laryngoscope 2014;124:1554–6.
3. 3. Gysin C, Dulguerov P. Hemorrhage after tonsillectomy: does the surgical technique really matter? ORL J Otorhinolaryngol Relat Spec 2013;75:123–32.
4. 4. Kaygusuz I, Alpay HC, Gödekmerdan A, et al. Evaluation of longterm impacts of tonsillectomy on immune functions of children: a follow-up study. Int J Pediatr Otorhinolaryngol 2009;73:445–9.
5. 5. Cengiz C, Erhan Y, Murat T, et al. Values of mean platelet volume in patients with chronic tonsillitis and adenoid hypertrophy. Pak J Med Sci 2013;29:569–72.
6. 6. Varol E, Ozturk O, Gonca T, et al. Mean platelet volume is increased in patients with severe obstructive sleep apnea. Scand J Clin Lab Invest 2010;70:497–502.
7. 7. Onder S, Caypinar B, Sahin-Yilmaz A, Toros SZ, Oysu C. Relation of mean platelet volume with obstructive adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 2014;78:1449– 551.
8. 8. Baugh RF, Archer SM, Mitchell RB, et al.; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 2011;144(1 Suppl):S1–30.

9. 9. Windfuhr JP, Werner JA. Tonsillotomy: it’s time to clarify the facts. Eur Arch Otorhinolaryngol 2013;270:2985–96.
10. 10. de la Chaux R, Klemens C, Patscheider M, Reichel O, Dreher A. Tonsillotomy in the treatment of obstructive sleep apnea syndrome in children: polysomnographic results. Int J Pediatr Otorhinolaryngol 2008;72:1411–7.
11. 11. Pfaar O, Spielhaupter M, Schirkowski A, et al. Treatment of hypertrophic palatine tonsils using bipolar radiofrequency-induced thermotherapy (RFITT). Acta Otolaryngol 2007;127:1176–81.
12. 12. Lister MT, Cunningham MJ, Benjamin B, et al. Microdebrider tonsillotomy vs electrosurgical tonsillectomy: a randomized, double- blind, paired control study of postoperative pain. Arch Otolaryngol Head Neck Surg 2006;132:6:599–604.
13. 13. Huber K, Sadick H, Maurer JT, Hörmann K, Hammerschmitt N. Tonsillotomy with the argon-supported monopolar needle – first clinical results. [Article in German] Laryngorhinootologie 2005; 84:671–5.
14. 14. Arya AK, Donne A, Nigam A. Double-blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain in children. Clin Otolaryngol 2005;30: 226–9.
15. 15. Goldbart AD, Mager E, Veling MC, et al. Neurotrophins and tonsillar hypertrophy in children with obstructive sleep apnea. Pediatr Res 2007;62:489–94.
16. 16. Svensson M, Venge P, Janson C, Lindberg E. Relationship between sleep-disordered breathing and markers of systemic inflammation in women from the general population. J Sleep Res 2012;21:147–54.
17. 17. Kim J, Hakim F, Kheirandish-Gozal L, Gozal D. Inflammatory pathways in children with insufficient or disordered sleep. Respir Physiol Neurobiol 2011;178:465–74.
18. 18. Imeri L, Opp MR. How (and why) the immune system makes us sleep. Nat Rev Neurosci 2009;10:199–210.
19. 19. Vgontzas AN. Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance? Arch Physiol Biochem 2008;114:211–23.
20. 20. Yu YH, Ginsberg HN. Adipocyte signaling and lipid homeostasis: sequelae of insulin-resistant adipose tissue. Circ Res 2005;96: 1042–52.
21. 21. Faraut B, Boudjeltia KZ, Vanhamme L, Kerkhofs M. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev 2012;16:137–49. 22. Sagit M, Korkmaz F, Kavugudurmaz M, Somdas MA. Impact of septoplasty on mean platelet volume levels in patients with marked nasal septal deviation. J Craniofac Surg 2012;23:974–6.
22. 23. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 2013;88:218–30.
23. 24. 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;102:653–7.
24. 25. Yenigun A, Karamanli H. Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome. J Laryngol Otol 2015;129:887–92.
25. 26. Korkmaz M, Korkmaz H, Küçüker F, Ayy›ld›z SN, Çankaya S. Evaluation of the association of sleep apnea-related systemic inflammation with CRP, ESR, and neutrophil-to-lymphocyte ratio. Med Sci Monit 2015;13:477–81.
26. 27. Koseoglu S, Ozcan KM, Ikinciogullari A, Cetin MA, Yildirim E, Dere H. Relationship between neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and obstructive sleep apnea syndrome. Adv Clin Exp Med 2015;24:623–7.
27. 28. Wang D, Yang JX, Cao DY, et al. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther 2013;6:211–6.
28. 29. Gary T, Pichler M, Belaj K, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.
29. 30. Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012;34:326–34.
30. 31. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol 2012;23:265–73.
31. 32. Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. J Thromb Thrombolysis 2015;39:179–85.