Skip to main content

Advertisement

Log in

A New Biomarker in Differentiation of Mucosal Chronic Otitis Media from Squamous Chronic Otitis Media: The Systemic Immune-Inflammation Index (SII)

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The Systemic Immune-inflammation Index (SII) is a new biomarker based on the number of neutrophils, platelets, and lymphocytes in the Complete blood count, and is shown as diagnostic and prognostic in many diseases. Mucosal or Squamous COM differentiation is necessary preoperatively in chronic otitis media patients. The purpose of this study was to test the predictive value of inflammation markers to predict the differentiation of Mucosal COM and Squamous COM. Our aim is; using "SII" as a powerful test to differentiate cholesteatoma and active mucosal middle ear disease. In the present study, 300 patients who underwent mastoidectomy ± tympanoplasty between 2010 and 2020 were retrospectively evaluated. The patients were divided into two equal groups as clinical, microscopically, and pathologically Squamosal COM (Cholesteatoma) and Mucosal COM (Suppurative) (n = 150). Routine hemogram tests were performed for both groups. White blood cell, red blood cell, neutrophil, lymphocyte, and platelet numbers were calculated. The SII value was calculated manually according to the formula of “neutrophil × platelet/lymphocyte. There were a total of 300 patients who were aged 20–63 in both groups. A total of 130 of these patients were male (43%), and 170 (57%) were female. In terms of NLR and PLR, Group 2 (Mucosal COM) had higher values at statistically significant levels (p < 0.001, p < 0.001, respectively). In terms of SII, Group 2 (Mucosal COM) had higher values at statistically significant levels (p < 0.001). According to the results of the ROC Analysis in our series, it was found that NLR, PLR, and SII values were above the acceptable level, and were statistically significant (p < 0.001, p < 0.001, p < 0.001, respectively). The cut-off value of SII was 470.29, sensitivity was 65.8, and specificity was 34. According to our study, high SII values in COM differentiation are very important in diagnosing Mucosal COM. SII values can help to the diagnosis in Squamous COM/Mucosal COM differentiation. There is no current practical, inexpensive, and widespread laboratory test used in the Mucosal/Squamous COM differentiation. SII can be diagnostic, and determine the treatment in this differentiation. A great number of studies are needed for SII values to become standard in COM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Rachidi S, Wallace K, Wrangle JM et al (2016) Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma. Head Neck 38:E1068–E1074. https://doi.org/10.1002/hed.24159

    Article  Google Scholar 

  2. Wallis S, Atkinson H, Coatesworth AP (2015) Chronic otitis media. Postgrad Med 127:391–395

    Article  Google Scholar 

  3. Shirai N, Preciado D (2019) Otitis media: what is new? Curr Opin Otolaryngol Head Neck Surg 27:495–498

    Article  Google Scholar 

  4. Kohles N, Schulz T, Eßer D (2015) Die chronische Otitis media. Laryngorhinootologie 94:776–789. https://doi.org/10.1055/s-0035-1565096

    Article  CAS  Google Scholar 

  5. Liu W, Yin T, Ren J et al (2014) Activation of the EGFR/Akt/NF-κB/cyclinD1 survival signaling pathway in human cholesteatoma epithelium. Eur Arch Oto Rhino Laryngol 271:265–273. https://doi.org/10.1007/s00405-013-2403-6

    Article  Google Scholar 

  6. Xie S, Xiang Y, Wang X et al (2016) Acquired cholesteatoma epithelial hyperproliferation: roles of cell proliferation signal pathways. Laryngoscope 126:1923–1930

    Article  Google Scholar 

  7. Salvago P, Rizzo S, Bianco A, Martines F (2017) Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes? Int J Audiol 56:148–153. https://doi.org/10.1080/14992027.2016.1236418

    Article  Google Scholar 

  8. Faria SS, Fernandes PC, Silva MJB et al (2016) The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience 10:702. https://doi.org/10.3332/ecancer.2016.702

    Article  Google Scholar 

  9. Kim DH, Oh JH, Kim J et al (2020) Predictive values of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and other prognostic factors in pediatric patients with Bell’s palsy. Ear Nose Throat J. https://doi.org/10.1177/0145561320922097

    Article  Google Scholar 

  10. Bucak A, Ulu S, Oruc S et al (2014) Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy. Laryngoscope 124:1678–1681. https://doi.org/10.1002/lary.24551

    Article  CAS  Google Scholar 

  11. Ulu S, Ulu MS, Bucak A et al (2013) Neutrophil-to-lymphocyte ratio as a new, quick, and reliable indicator for predicting diagnosis and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol 34:1400–1404. https://doi.org/10.1097/MAO.0b013e31829b57df

    Article  Google Scholar 

  12. Oya R, Takenaka Y, Imai T et al (2019) Neutrophil-to-lymphocyte ratio and platelet- to-lymphocyte ratio as prognostic hematologic markers of Bell’s palsy: a meta-analysis. Otol Neurotol 40:681–687

    Article  Google Scholar 

  13. Cayir S, Kilicaslan C (2020) Hematologic parameters as predictive markers in pediatric Bell’s palsy. Eur Arch Oto Rhino Laryngology. https://doi.org/10.1007/s00405-020-06459-w

    Article  Google Scholar 

  14. Eryilmaz A, Basal Y, Tosun A et al (2015) The neutrophil to lymphocyte ratios of our pediatric patients with Bell’s palsy. Int J Pediatr Otorhinolaryngol 79:2374–2377. https://doi.org/10.1016/j.ijporl.2015.10.047

    Article  Google Scholar 

  15. Elbistanli MS, Koçak HE, Acipayam H et al (2017) The predictive value of neutrophil-lymphocyte and platelet-lymphocyte ratio for the effusion viscosity in otitis media with chronic effusion. J Craniofac Surg 28:e244–e247. https://doi.org/10.1097/SCS.0000000000003452

    Article  Google Scholar 

  16. Bakshi SS (2018) Neutrophil-lymphocyte and platelet-lymphocyte ratio for the effusion viscosity in Otitis Media. J Craniofac Surg 29:e98

    Article  Google Scholar 

  17. Boztepe OF, Demir M, Gün T et al (2015) A novel predictive marker for the viscosity of otitis media with effusion. Int J Pediatr Otorhinolaryngol 79:2355–2358. https://doi.org/10.1016/j.ijporl.2015.10.043

    Article  Google Scholar 

  18. Yukkaldıran A, Erdoğan O, Kaplama ME (2020) Neutrophil-lymphocyte and platelet-lymphocyte ratios in otitis media with effusion in children: diagnostic role and audiologic correlations. Int J Clin Pract. https://doi.org/10.1111/ijcp.13805

    Article  Google Scholar 

  19. Klllçkaya MM, Aynali G, Tuz M, Bagcl Ö (2017) Is there a systemlc inflammatory effect of cholesteatoma? Int Arch Otorhinolaryngol 21:42–45. https://doi.org/10.1055/s-0036-1584363

    Article  Google Scholar 

  20. Tansuker HD, Eroğlu S, Yenigün A et al (2017) Can serum neutrophil-to-lymphocyte ratio be a predictive biomarker to help differentiate active chronic otitis media from inactive Chronic Otitis Media? J Craniofac Surg 28:e260–e263. https://doi.org/10.1097/SCS.0000000000003484

    Article  Google Scholar 

  21. Eryilmaz MA, Derin S (2016) Mean platelet volume as a potential predictor of cholesteatoma in children. J Craniofac Surg 27:e575–e578. https://doi.org/10.1097/SCS.0000000000002881

    Article  Google Scholar 

  22. Baysal E, Aksoy N, Kara F et al (2013) Oxidative stress in chronic otitis media. Eur Arch Otorhinolaryngol 270:1203–1208. https://doi.org/10.1007/s00405-012-2070-z

    Article  Google Scholar 

Download references

Funding

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

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Erkan Yıldız.

Ethics declarations

Conflict of interest

No conflict of interest was declared by the authors.

Ethical standard

Ethics committee approval was received from Afyonkarahisar Healty Science University Clinical Research Ethic Committee (01.03.2021-2021/2).

Informed consent

Consent was obtained from of the patients.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The English translation, editing and proofreading procedures of this article were carried out by "Academic Translation Services (www.tercumeakademik.com)".

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yıldız, E., Kuzu, S., Günebakan, Ç. et al. A New Biomarker in Differentiation of Mucosal Chronic Otitis Media from Squamous Chronic Otitis Media: The Systemic Immune-Inflammation Index (SII). Indian J Otolaryngol Head Neck Surg 74, 476–482 (2022). https://doi.org/10.1007/s12070-021-02857-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-021-02857-6

Keywords

Navigation