Prognostic Value of Systemic Inflammatory Biomarkers in Sudden Sensorineural Hearing Loss

Objective: To analyze the prognostic significance of systemic inflammatory markers in cases of sudden sensorineural hearing loss (SSNHL), namely NLR, LMR, PLR, SII, ESR, and CRP. Methods: This retrospective, case-controlled study included 54 SSNHL patients from our hospital's otorhinolaryngology department. The medical files of the SSNHL patients and control (30 cases) groups were analyzed to obtain data on demographics, clinical evaluation, pure tone audiometry results (PTA), and blood biomarkers, including Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), Platelet-to-Lymphocyte (PLR), Systemin Inflammatory Index (SII), C-Reactive Protein (CRP), and Erythrocyte Sedimentation Rate (ESR). Siegel's criteria were used to evaluate hearing recovery at baseline and three months later, and patients were classified as either responders or non-responders. Results: Patients with SSNHL exhibited significantly high NLR (p<0.001), PLR (p=0.003), SII (p<0.001), ESR (p<0.001), and CRP (p<0.001) and significantly decreased LMR (p<0.001). Significant differences were noticed between responder and non-responder groups in NLR (p<0.001), PLR (p = 0.003), LMR (p<0.001), and SII (p<0.001). Prognostic performance (sensitivity and specificity) for NLR, LMR, PLR, and SII to predict responders was statistically significant (p<0.001 for NLR, LMR, SII and p=0.003 for PLR). For prognostic value, our in-depth analysis showed cut-off value for NLR, LMR, PLR, and SII ( ≤3.473, >3.121, ≤143, ≤950.1, respectively). Conclusion: Inflammatory processes and compromised microvascular function may be indicated by higher NLR, PLR, and SII and decreased LMR levels in SSNHL. Based on our comparison of responders and non-responders, these biomarkers may be a useful predictive tool for predicting treatment outcome.