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Blood Inflammatory Markers as Predictors of Effusion Characteristics and Postoperative Hearing Outcomes in Children
Amani Abdullah Almutairi1, Ibrahim K Aljabr2, Zahra Saleh Alsindi1
1College of Medicine, King Faisal University, Al Hofuf P.O. Box 400, Saudi Arabia.
Insights
Preoperative inflammatory markers like neutrophil count can predict effusion type in otitis media with effusion (OME) and short-term hearing outcomes after adenoidectomy. Elevated markers indicate mucoid OME and potential temporary hearing loss.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Immunology
Background:
- Otitis media with effusion (OME) and obstructive adenoid hypertrophy (OAH) are major causes of pediatric hearing loss.
- Distinguishing OME effusion types and predicting hearing recovery post-surgery remain clinical challenges.
- Preoperative blood inflammatory markers are explored for their predictive utility.
Purpose of the Study:
- To evaluate the role of preoperative blood inflammatory markers in predicting effusion characteristics (serous vs. mucoid) in OME.
- To assess the correlation between these markers and short-term hearing outcomes following adenoidectomy with tympanostomy tube (TT) insertion.
- To identify potential prognostic tools for surgical planning and patient counseling in pediatric OME.
Main Methods:
- Retrospective cohort study of 232 children under 12 undergoing adenoidectomy.
- Patients categorized into serous OME (n=42), mucoid OME (n=78), and non-effusion (n=112) groups.
- Analysis of preoperative blood counts (neutrophils, lymphocytes, eosinophils, platelets) and derived indices (NLR, PLR, SII, MPV, EBR).
Main Results:
- Mucoid OME patients showed significantly higher neutrophils, platelets, eosinophils, NLR, and SII compared to serous OME and non-effusion groups.
- All serous OME children achieved normal hearing post-op; 15.4% of mucoid OME cases had transient mild hearing loss persisting beyond 2 weeks.
- Preoperative neutrophil count independently predicted delayed hearing recovery (p=0.021).
Conclusions:
- Systemic inflammatory markers, particularly neutrophil count, NLR, and SII, effectively differentiate mucoid OME.
- These markers correlate with short-term hearing recovery, with elevated neutrophils predicting delayed recovery.
- Neutrophil count shows promise as a prognostic tool for surgical planning and patient counseling in pediatric OME management.
Abstract:
Background and Objectives: Otitis media with effusion (OME), frequently associated with obstructive adenoid hypertrophy (OAH), is a leading cause of paediatric hearing loss. Clinically distinguishing effusion types (serous vs. mucoid) and predicting postoperative hearing recovery are unresolved challenges. This study evaluated the utility of preoperative blood inflammatory markers in predicting effusion characteristics and short-term hearing outcomes following adenoidectomy with tympanostomy tube (TT) insertion. Materials and Methods: In this retrospective cohort study, 232 children under 12 years old in 2024 and undergoing adenoidectomy (with or without TT insertion) were categorised into serous OME (n = 42), mucoid OME (n = 78), and non-effusion (n = 112) groups. Preoperative blood sample analyses assessed neutrophil, lymphocyte, eosinophil, basophil, and platelet counts, along with derived indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-basophil ratio (EBR), mean platelet volume (MPV), and systemic immune-inflammation index (SII). Hearing was evaluated at 2 weeks and 1 month postoperatively. Statistical analyses used SPSS v.28, with significance set at p < 0.05. Result: Mucoid OME patients exhibited significantly elevated neutrophil counts, platelet counts, eosinophils, NLR, and SII compared to those in serous OME and non-effusion groups (p < 0.05). All serous OME children achieved normal hearing by the first follow-up, whereas 15.4% of mucoid OME cases had transient mild hearing loss persisting after 2 weeks (p = 0.008; OR=15.97) but resolving by 1 month. Preoperative neutrophil count independently predicted delayed hearing recovery (p = 0.021). Conclusions: Systemic inflammatory markers, particularly neutrophil count, NLR, and SII, effectively differentiate mucoid OME from other effusion types and correlate with short-term hearing recovery. Neutrophil count may serve as a prognostic tool for surgical planning and patient counselling. Prospective studies are warranted to validate these findings in broader paediatric populations.
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