Araştırma Makalesi
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Timpanoplasti Sonrası Greft Başarısızlığı ile Sigara Kullanımı ve Preoperatif İnflamatuar Belirteçler Arasındaki İlişkinin Değerlendirilmesi

Yıl 2025, Cilt: 12 Sayı: 2, 34 - 42, 31.08.2025
https://doi.org/10.56941/odutip.1735562

Öz

Bu çalışma, farklı tekniklerle timpanoplasti uygulanan hastalarda greft başarısı ile sigara kullanımı durumu ve preoperatif tam kan sayımına (CBC) dayalı inflamatuar belirteçler (CRP, WBC, NLR, PLR, RDW) arasındaki ilişkiyi araştırmayı amaçlamaktadır. Bu retrospektif çalışmaya, 2023 ile 2025 yılları arasında kliniğimizde timpanoplasti ameliyatı geçiren 40 hasta dâhil edilmiştir. Hastalar, greft başarısına göre başarısız ve başarılı olmak üzere iki gruba ayrılmıştır. Sigara içme durumu, cerrahi teknik ve inflamatuar laboratuvar parametreleri kaydedilmiştir. İstatistiksel analizlerde Fisher’s Exact Test, Ki-kare Testi ve Mann–Whitney U Testi kullanılmıştır (p < 0.05 anlamlı kabul edilmiştir). Sigara içme durumu ile greft başarısızlığı arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur (p = 0.001). CRP düzeyleri istatistiksel olarak anlamlı olmamakla birlikte sınırda anlamlılık göstermiştir (p = 0.055). Greft sonuçları ile WBC, NLR, PLR ve RDW gibi diğer inflamatuar belirteçler arasında anlamlı bir ilişki gözlenmemiştir. Uygulanan cerrahi tekniklerin de greft başarısını anlamlı şekilde etkilemediği görülmüştür (p = 0.144). Bu bulgular, greft başarısını artırmak için hastalara ameliyat öncesi sigarayı bırakmalarının önerilmesinin önemini ortaya koymaktadır.

Kaynakça

  • Lin Y-C, Wang W-H, Weng H-H, Lin Y-C. Predictors of surgical and hearing long-term results for inlay cartilage tympanoplasty. Archives of Otolaryngology–Head & Neck Surgery. 2011;137(3):215-9.
  • Motran CC, Silvane L, Chiapello LS, Theumer MG, Ambrosio LF, Volpini X, et al. Helminth infections: recognition and modulation of the immune response by innate immune cells. Frontiers in immunology. 2018;9:664.
  • Yılmaz B, Şengül E, Gül A, Alabalık U, Özkurt FE, Akdağ M, et al. Neutrophil–lymphocyte ratio as a prognostic factor in laryngeal carcinoma. Indian Journal of Otolaryngology and Head & Neck Surgery. 2018;70(2):175-9.
  • Li B, Gao B, Zhu H-J, Luwor RB, Lu J, Zhang L, et al. The Prognostic Value of Preoperative Inflammatory Markers for Pathological Grading of Glioma Patients. Technology in Cancer Research & Treatment. 2024;23:15330338241273160.
  • Atan D, Özcan KM, Köseoğlu S, İkincioğulları A, Çetin MA, Ensari S, et al. New predictive parameters of nasal polyposis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Kulak Burun Bogaz Ihtisas Dergisi: KBB= Journal of Ear, Nose, and Throat. 2015;25(2):97-101.
  • Boztepe OF, Gün T, Demir M, Gür ÖE, Ozel D, Doğru H. A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery. European Archives of Oto-Rhino-Laryngology. 2016;273(6):1439-44.
  • Kurtul A, Ornek E. Platelet to lymphocyte ratio in cardiovascular diseases: a systematic review. Angiology. 2019;70(9):802-18.
  • Çınar Z, Yiğit Ö, Sünter AV. Timpanoplasti Sonrası Greft Başarısını Ön Görmede Tam Kan Sayımı Enflamasyon Belirteçleri Kullanılabilir mi? Istanbul Medical Journal. 2020.
  • Onal K, Arslanoglu S, Songu M, Demiray U, Demirpehlivan I. Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media. The Journal of Laryngology & Otology. 2012;126(1):22-5.
  • Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta‐analysis of comparative studies. The Laryngoscope. 2017;127(9):2139-48.
  • Mohanty S, Manimaran V, Umamaheswaran P, Jeyabalakrishnan S, Chelladurai S. Endoscopic cartilage versus temporalis fascia grafting for anterior quadrant tympanic perforations—a prospective study in a tertiary care hospital. Auris Nasus Larynx. 2018;45(5):936-42.
  • Naderpour M, Moghadam YJ, Ghanbarpour E, Shahidi N. Evaluation of factors affecting the surgical outcome in tympanoplasty. Iranian journal of otorhinolaryngology. 2016;28(85):99.
  • Cekici Y, Yılmaz M, Seçen Ö. New inflammatory indicators: association of high eosinophil-to-lymphocyte ratio and low lymphocyte-to-monocyte ratio with smoking. Journal of International Medical Research. 2019;47(9):4292-303.
  • Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, Paltura C, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx. 2015;42(1):20-3.
  • Cox MD, Anderson SR, Russell JS, Dornhoffer JL. The impact of smoking on ossiculoplasty outcomes. Otology & Neurotology. 2016;37(6):721-7.
  • He JR, Shen GP, Ren ZF, Qin H, Cui C, Zhang Y, et al. Pretreatment levels of peripheral neutrophils and lymphocytes as independent prognostic factors in patients with nasopharyngeal carcinoma. Head & neck. 2012;34(12):1769-76.
  • Bardash Y, Olson C, Herman W, Khaymovich J, Costantino P, Tham T. Platelet-lymphocyte ratio as a predictor of prognosis in head and neck cancer: a systematic review and meta-analysis. Oncology Research and Treatment. 2019;42(12):665-77.
  • Kang JW, Kim MG, Kim SS, Im H-I, Dong SH, Kim SH, et al. Neutrophil-lymphocyte ratio as a valuable prognostic marker in idiopathic sudden sensorineural hearing loss. Acta oto-laryngologica. 2020;140(4):307-13.
  • Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? European Archives of Oto-Rhino-Laryngology. 2018;275(2):409-13.

Evaluation of the relationship between graft failure after tympanoplasty and smoking status and preoperative inflammatory markers

Yıl 2025, Cilt: 12 Sayı: 2, 34 - 42, 31.08.2025
https://doi.org/10.56941/odutip.1735562

Öz

This study aimed to investigate the relationship between graft success in patients undergoing tympanoplasty with various techniques and smoking status, as well as preoperative complete blood count (CBC)-based inflammatory markers (CRP, WBC, NLR, PLR, RDW). This retrospective study included 40 patients who underwent tympanoplasty in our clinic between 2023 and 2025. Patients were divided into two groups based on graft success as not-failed and failed. Smoking status, surgical technique, and inflammatory laboratory parameters were recorded. Fisher’s Exact Test, Chi-square Test, and Mann–Whitney U Test were used for statistical analyses (p < 0.05 was considered significant). A statistically significant association was found between smoking status and graft failure (p = 0.001). CRP levels were not statistically significant (p = 0.055), but showed borderline results. No significant relationship was observed between graft outcomes and other inflammatory markers such as WBC, NLR, PLR, and RDW. Surgical techniques also did not significantly affect graft success (p = 0.144). These findings shows the importance of advising patients to stop smoking before surgery to improve the graft success rates.

Etik Beyan

This study was approved by the Committee of Ethics (ıBAEK-324) of the Giresun Training and Research Hospital.

Kaynakça

  • Lin Y-C, Wang W-H, Weng H-H, Lin Y-C. Predictors of surgical and hearing long-term results for inlay cartilage tympanoplasty. Archives of Otolaryngology–Head & Neck Surgery. 2011;137(3):215-9.
  • Motran CC, Silvane L, Chiapello LS, Theumer MG, Ambrosio LF, Volpini X, et al. Helminth infections: recognition and modulation of the immune response by innate immune cells. Frontiers in immunology. 2018;9:664.
  • Yılmaz B, Şengül E, Gül A, Alabalık U, Özkurt FE, Akdağ M, et al. Neutrophil–lymphocyte ratio as a prognostic factor in laryngeal carcinoma. Indian Journal of Otolaryngology and Head & Neck Surgery. 2018;70(2):175-9.
  • Li B, Gao B, Zhu H-J, Luwor RB, Lu J, Zhang L, et al. The Prognostic Value of Preoperative Inflammatory Markers for Pathological Grading of Glioma Patients. Technology in Cancer Research & Treatment. 2024;23:15330338241273160.
  • Atan D, Özcan KM, Köseoğlu S, İkincioğulları A, Çetin MA, Ensari S, et al. New predictive parameters of nasal polyposis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Kulak Burun Bogaz Ihtisas Dergisi: KBB= Journal of Ear, Nose, and Throat. 2015;25(2):97-101.
  • Boztepe OF, Gün T, Demir M, Gür ÖE, Ozel D, Doğru H. A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery. European Archives of Oto-Rhino-Laryngology. 2016;273(6):1439-44.
  • Kurtul A, Ornek E. Platelet to lymphocyte ratio in cardiovascular diseases: a systematic review. Angiology. 2019;70(9):802-18.
  • Çınar Z, Yiğit Ö, Sünter AV. Timpanoplasti Sonrası Greft Başarısını Ön Görmede Tam Kan Sayımı Enflamasyon Belirteçleri Kullanılabilir mi? Istanbul Medical Journal. 2020.
  • Onal K, Arslanoglu S, Songu M, Demiray U, Demirpehlivan I. Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media. The Journal of Laryngology & Otology. 2012;126(1):22-5.
  • Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta‐analysis of comparative studies. The Laryngoscope. 2017;127(9):2139-48.
  • Mohanty S, Manimaran V, Umamaheswaran P, Jeyabalakrishnan S, Chelladurai S. Endoscopic cartilage versus temporalis fascia grafting for anterior quadrant tympanic perforations—a prospective study in a tertiary care hospital. Auris Nasus Larynx. 2018;45(5):936-42.
  • Naderpour M, Moghadam YJ, Ghanbarpour E, Shahidi N. Evaluation of factors affecting the surgical outcome in tympanoplasty. Iranian journal of otorhinolaryngology. 2016;28(85):99.
  • Cekici Y, Yılmaz M, Seçen Ö. New inflammatory indicators: association of high eosinophil-to-lymphocyte ratio and low lymphocyte-to-monocyte ratio with smoking. Journal of International Medical Research. 2019;47(9):4292-303.
  • Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, Paltura C, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx. 2015;42(1):20-3.
  • Cox MD, Anderson SR, Russell JS, Dornhoffer JL. The impact of smoking on ossiculoplasty outcomes. Otology & Neurotology. 2016;37(6):721-7.
  • He JR, Shen GP, Ren ZF, Qin H, Cui C, Zhang Y, et al. Pretreatment levels of peripheral neutrophils and lymphocytes as independent prognostic factors in patients with nasopharyngeal carcinoma. Head & neck. 2012;34(12):1769-76.
  • Bardash Y, Olson C, Herman W, Khaymovich J, Costantino P, Tham T. Platelet-lymphocyte ratio as a predictor of prognosis in head and neck cancer: a systematic review and meta-analysis. Oncology Research and Treatment. 2019;42(12):665-77.
  • Kang JW, Kim MG, Kim SS, Im H-I, Dong SH, Kim SH, et al. Neutrophil-lymphocyte ratio as a valuable prognostic marker in idiopathic sudden sensorineural hearing loss. Acta oto-laryngologica. 2020;140(4):307-13.
  • Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? European Archives of Oto-Rhino-Laryngology. 2018;275(2):409-13.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kulak Burun Boğaz
Bölüm Araştırma Makalesi
Yazarlar

Volkan Gungor 0000-0003-1237-9751

Kaan Turan Tercan 0009-0002-8219-2466

Gönderilme Tarihi 6 Temmuz 2025
Kabul Tarihi 21 Ağustos 2025
Yayımlanma Tarihi 31 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 12 Sayı: 2

Kaynak Göster

Vancouver Gungor V, Tercan KT. Evaluation of the relationship between graft failure after tympanoplasty and smoking status and preoperative inflammatory markers. ODU Tıp Derg. 2025;12(2):34-42.