Authors : Rahmat Faradilla; Azwar Ridwan; Benny Kurnia; Lily Setiani; Dina Alia

Volume/Issue : Volume 10 - 2025, Issue 8 - August

Google Scholar : https://tinyurl.com/22pa9mtk

Scribd : https://tinyurl.com/2s39y3xm

DOI : https://doi.org/10.38124/ijisrt/25aug1544

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Abstract : Background: Tissue damage due to microbial invasion in CSOM cases causes inflammatory mechanisms related to specific and non-specific immunity. Neutrophil Lymphocyte Ratio (NLR) is an inflammatory marker in CSOM as a prognostic indicator of the disease.  Objective: To determine the role of NLR as determinant inflammatory parameters of CSOM in predicting disease prognosis.  Methods: Analytical observational study with cross sectional design. Sample collection was conducted December 2022-March 2023. There were safe type dry phase CSOM, safe type active phase and dangerous type. The safe type active phase CSOM and dangerous type were given topical antibiotics for 2 weeks. Complete blood Count were repeated to assess NLR after 2 weeks in all types of CSOM. Data analysis used the Kruskal-Wallis alternative test and Spearman rank correlation.  Results: A total of 27 samples involved men (55.6%) and women (44.4%). Based on CSOM type, there were 40.8% of safe type dry phase CSOM, 29.6% safe type active phase and 29.6% dangerous type. The average of NLR value were found significantly different both the beginning (p-value=0.004) and the end (p-value=0.010). Comparison of three types of CSOM in the beginning and the end showed significant decrease (p-value <0.05).  Conclusion: NLR could not be used as a prognostic indicator in the three types of CSOM, because it is included in the very weak category.

Keywords : Neutrophil Lymphocyte Ratio, Chronic Suppurative Otitis Media (CSOM), Inflammatory Parameters.

References :

1. Suryani L, Widuri A. Chronic Suppurative Otitis Media Characteristic in Secondary Hospital in Yogyakarta. Open Access Maced J Med Sci. 2021;9(T5):152–6.
2. Indonesia KMKR. Pedoman Nasional Pelayanan Kedokteran Tatalaksana Otitis Media Supuratif Kronik. Nucleic Acids Res. 2018;6(1):1–7.
3. Hatice Terzi, Kasım Durmuş , Tuba Doğan Karataş , Mehmet Şencan EEA. Inflammation‑Based Prognostic Factor in Different Forms of Chronic Suppurative Otitis Media. Indian J Otol. 2017;23(4):256–9.
4. Mendez, Digna C, Rosario, Magda D. Chronic Suppurative Otitis. StatPearls Publishing; 2023.
5. Mahdiani S, Lasminingrum L, Anugrah D. Management evaluation of patients with chronic suppurative otitis media: A retrospective study. Ann Med Surg. 2021;67(38):102492. Available from: https://doi.org/10.1016/j.amsu.2021.102492
6. Alkatiri FBB. Kriteria diagnosis dan penatalaksanaan otitis media supuratif kronis. Intisari Sains Medis. 2019;5(1):100–5.
7. Bellad SA, Kavi A, Mudhol RS. Prevalence of Chronic Suppurative Otitis Media Among School Children Residing in Rural Area of Belagavi, South India. Indian J Otolaryngol Head Neck Surg. 2019;71(s2):1549–52. Available from: https://doi.org/10.1007/s12070-019-01627-9
8. Sari MRN IM. The relationship between clean and healthy lifestyle with chronic suppurative otitis media. Lampung University; 2020.
9. Clearinsyah EP, Lopo C, Sabir M. Karakteristik Otitis Media Supuratif Kronik di Poliklinik THT RSUD Undata Palu Tahun 2017. J Med Prof. 2021;3(1):1–7.
10. Fita S. Perbandingan Terapi Ofloksasin Oral dengan Topikal pada OMSK Tipe Aman Fase Aktif di RSUDZA Banda Aceh. Universitas Syiah Kuala; 2021.
11. Ashurst. ADJ V. Acute Otitis Media. StatPearls Publishing; 2023.
12. Hayati Z, Maulina N AR. Dasar-dasar imunologi dan infeksi. Syiah Kuala University Press. Syiah Kuala University Press; 2021. 22 p.
13. Ghobadi H, Mohammadshahi J, Javaheri N, Fouladi N, Mirzazadeh Y, Aslani MR. Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients. Front Med. 2022;9.
14. Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases. Int J Mol Sci. 2022;23(7).
15. Seo YJ, Park YA, Bong JP, Park DJ, Park SY. Predictive value of neutrophil to lymphocyte ratio in first-time and recurrent idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx. 2015;42(6):438–42. Available from: http://dx.doi.org/10.1016/j.anl.2015.04.011
16. Sakalli E, Temirbekov D, Turkmen E, Celikyurt C. The neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and mean platelet volume in patients with chronic otitis media and cholesteatoma. Ann Med Res. 2019;26(9):2002.
17. Dewi NP ZD. Characteristic of Chronic Suppurative Otitis Media at H. Adam Malik Hospital Medan. E- Journal FK USU. 2013;1(2):1–6.
18. Khrisna EA, Sudipta IM. Karakteristik Pasien Otitis Media Supuratif Kronis Di Rsup Sanglah Denpasar Tahun 2015. J Med Udayana. 2019;8(8):7–11.
19. Pangemanan DM, Palandeng OI, Pelealu OC. Otitis Media Supuratif Kronik di Poliklinik THT-KL RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2014 – Desember 2016. e-CliniC. 2018;6(1).
20. Lisa A., Wibawa F. Karakteristik Penderita Otitis Media Supuratif Kronis (Omsk) Di Poliklinik Tht-Kl Rsud Dr. H. Abdul Moeloek Bandar Lampung Periode Januari 2013-Desember 2014. J Chem Inf Model. 2019;53(9):1689–99.
21. Monganisa Alwy P, Zachreini I, Sawitri H. Hubungan Usia Dan Jenis Kelamin Dengan Kejadian Otitis Media Supuratif Kronik Di Rumah Sakit Umum Daerah Cut Meutia Tahun 2019-2020. J Ilm Mns Dan Kesehat. 2023;6(1):123–31.
22. Srivastava A, Singh R, Varshney S, Gupta P, Bist S, Bhagat S, et al. Microbiological Evaluation of an Active Tubotympanic Type of Chronic Suppurative Otitis Media. Nepal J ENT Head Neck Surg. 1970;1(2):14–6.
23. Loy AHC, Tan AL, Lu KS, Lu PKS, Loy A. Microbiology of Chronic Suppurative Otitis Media in Singapore Division of Otolaryngology Changi General Hospital 2 Simei Street 3 Singapore 529889. 2002;43(6):296–9.
24. Yun JM, Chung MK, Baek CH, Son YI, Ahn MJ, Oh D, et al. Prognostic Significance of the Post- Treatment Neutrophil-to-Lymphocyte Ratio in Pharyngeal Cancers Treated with Concurrent Chemoradiotherapy. Cancers (Basel). 2023;15(4).
25. İşlek A, Balcı MK, Şimşek S. Correlation of the Neutrophil-to-Lymphocyte Ratio with the Middle Ear Risk Index in Patients with Chronic Otitis Media. Indian J Otolaryngol Head Neck Surg. 2022;74(December):4603–7.
26. Sakarozi R, Susilo DH, Wibowo MD. The Use of Neutrophil – Lymphocyte Ratio (NLR) as a Potential Biomarker to Predict the Prognosis of Ludwig’s Angina Patients. Bali Med J. 2022;11(3):1553–8.