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Jin F, Yu E, Chen J, Zhou W, Cai H, Hu J, Xuan L. Monocyte to high-density lipoprotein ratio as a novel-potential biomarker for predicting prognosis of Bell's palsy. Eur Arch Otorhinolaryngol 2024; 281:2293-2301. [PMID: 38015248 DOI: 10.1007/s00405-023-08340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES In several disorders, the monocyte to high-density lipoprotein ratio (MHR) has been considered a biomarker of systemic inflammation and oxidative stress. However, its role in Bell's palsy (BP) remains unclear. This study investigates the relationship between elevated MHR and poor recovery in BP patients. METHODS The clinical data of 729 BP patients were analyzed retrospectively. The House-Brackmann Facial Nerve Grading System (H-B) was utilized to assess the severity of facial motor dysfunction during admission and the follow-up period after discharge. According to the 6 months follow-up data, H-B grades 1-2 were classified as recovered (n = 557), and H-B grades 3-6 as unrecovered (n = 172). The patients were split into MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups based on the median MHR to further analyze the connection between different MHRs and prognosis. RESULTS The level of MHR was substantially greater in the unrecovered group of BP patients than in the restored group (medians[interquartile range], 0.32[0.20, 0.49] vs 0.24[0.11, 0.39], P < 0.001). MHR was an independent risk factor for BP prognosis as indicated by the multivariate logistic regression analysis (OR = 4.467, 95% CI = 1.875-10.646, P = 0.001). The area under the curve (AUC) was 0.615 (95% CI = 0.566-0.664, P < 0.001). The initial H-B score did not differ significantly between MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups. However, after 6 months of follow-up, the high-MHR group's H-B score was considerably greater than the low-MHR group's. CONCLUSIONS MHR is expected to be an accessible and effective biomarker of BP. In BP patients, elevated MHR is related to an increased chance of poor recovery.
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Affiliation(s)
- Fanyuan Jin
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Erhui Yu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Junkang Chen
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Wenhui Zhou
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Huafeng Cai
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Jinhua Hu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Lihua Xuan
- The First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China.
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Tabassum A, Nadeem H, Azeem F, Siddique MH, Zubair M, Kanwal A, Rasul I. An integrated network pharmacology approach to discover therapeutic mechanisms of Commiphora wightii for the treatment of Bell's palsy. J Biomol Struct Dyn 2024:1-18. [PMID: 38502688 DOI: 10.1080/07391102.2024.2326196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
Bell's palsy (BP) can result in facial paralysis. Inflammation or injury to the cranial nerves that regulate the facial muscles is primarily responsible for that disease. Commiphora wightii remains recognized as a cure for a few human ailments. This study focused on therapeutic phenomena of C. wightii for the treatment of Bell's palsy, utilizing the network drug discovery and molecular docking techniques. Active biological constituents of C. wightii were retrieved from literature and independent databases. Potential therapeutic targets (431) of 13 bioactive phytochemicals were fetched via SwissTargetPrediction tool. Putative intersecting targets (855) of Bell's palsy were computed through the DisGeNET and GeneCards datasets. Subsequently, by the analysis of potential shared targets (87) of C. wightii and Bell's palsy, a Venn diagram was drawn. DAVID database was used to evaluate gene functional annotations and enriched pathways that are involved in Bell's palsy. STRING database was used for generating the protein-protein relationship complex. Visual presentations of the interactions of potential targets to active chemical constituents were done by the Cytoscape. Whereas, the conformational research sorted out 10 key targets through the protein-protein interactions network. Moreover, the capacity of therapeutic ingredients to interact with a target inhibiting Bell's palsy was confirmed by molecular docking, which might ratify the findings of network pharmacology. In the molecular complex of AKT1-cholesterol, a 100-ns simulation unveiled a graceful stability, with a minimal 0.167 Å ligand shift and resilient hydrogen bonds (ASN54 and SER205). The final 20 ns showcased a P1 motif pirouette, gracefully forming aromatic bonds with H165 and W186, underscoring the complex's dynamic finesse. This study evaluated compound-target interactions and their impact on disease-related genes. It revealed that five genes (AKT1, TNF, MAPK3, EGFR and SRC) of C. wightii might be useful therapeutic targets for the treatment of Bell's palsy, as well as helping in lowering down the blood pressure.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Ayesha Tabassum
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Habibullah Nadeem
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Farrukh Azeem
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Hussnain Siddique
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Zubair
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Aqsa Kanwal
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Ijaz Rasul
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
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Zhang H, Chen F. Efficacy of Electroacupuncture with Sparse-Dense-Wave on Patients Suffered Acute Facial Paralysis. Clin Cosmet Investig Dermatol 2023; 16:1811-1819. [PMID: 37483469 PMCID: PMC10361404 DOI: 10.2147/ccid.s405569] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023]
Abstract
Objective To explore the efficacy of electroacupuncture (EA) with sparse-dense wave form on the improvement of facial nerve edema, facial spasm, and repair of nerve injury in patients with acute facial paralysis. Methods This study enrolled 100 patients who were treated for acute facial paralysis in People's Hospital of Dongxihu District from December 2019 to December 2020. They were randomly divided into the control group (continuous wave) and the sparse-dense wave group (sparse-dense wave), following by being intervened by EA with different wave forms. Then the facial disability index (FDI) score, serum levels of immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) in the two groups were evaluated. Results The total effectiveness rate (98.00% and 86.00%, respectively; P < 0.05) and the recovery rate of facial spasm (76.00% and 56.00%, respectively; P<0.05) in the sparse-dense wave group was both significantly higher than that of the control group. After treatment, the scores of physical functions of patients in both groups increased (P < 0.05), the scores of social/well-being dysfunctions decreased (P < 0.05). Besides, the levels of serum IgA, IgG, and IgM in both groups decreased (P < 0.05), and the serum levels in the sparse-dense wave group were significantly lower than the control group (P < 0.05). Conclusion EA intervention with sparse-dense wave form is effective for patients with acute facial paralysis, in that it effectively reduced the occurrence of facial spasm and promoted the improvement of edema and repair of nerve injury.
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Affiliation(s)
- Hao Zhang
- Department of Traditional Chinese Medicine, People’s Hospital of Dongxihu District, Wuhan, Hubei, 430040, People’s Republic of China
| | - Fan Chen
- Department of Traditional Chinese Medicine, People’s Hospital of Dongxihu District, Wuhan, Hubei, 430040, People’s Republic of China
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Predictive values of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and other prognostic factors in pediatric vestibular neuritis patients. Int J Pediatr Otorhinolaryngol 2023; 164:111383. [PMID: 36436319 DOI: 10.1016/j.ijporl.2022.111383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/26/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the relationship between severity and hemodynamic factor in pediatric vestibular neuritis patients and find out their effectiveness as a prognostic factor. STUDY DESIGN Retrospective review. SETTING Tertiary medical center. PATIENTS Pediatric patients diagnosed between January 2010 and December 2019 at a tertiary medical institution who were hospitalized with dizziness. MAIN OUTCOME MEASURE A study of the duration of spontaneous nystagmus loss and the severity of the disease using questionnaires (PVSQ, DHI) in pediatric patients admitted to Vestibular neuritis (VN) and correlation with NLR, PLR, MPV and RDW conducted at the time of admission. RESULT This study was conducted on 22 children with VN and 30 children in control group. For the evaluate of the severity of the symptoms of VN patients, two group were classified based on the period from the onset of the symptom to the loss of the spontaneous nystagmus.: mild VN and severe VN, and the PVSQ and DHI questionnaires were used to assess the degree of improvement. PVSQ and DHI score generally improved during spontaneous nystagmus loss, and comparing the severity of the symptoms with the values of NLR, PLR, MPV and RDW showed a positive correlation between the severity of the symptoms and the value of the NLR and PLR value. CONCLUSION NLR, PLR value is thought to be an efficient indicator of pediatric VN patents and could be a clue to the current unknown cause of childhood VN disease.
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Yang LS, Zhou DF, Zheng SZ, Zhao BM, Li HG, Chen QQ, Zhong Y, Yang HZ, Zhang K, Tang CZ. Early intervention with acupuncture improves the outcome of patients with Bell's palsy: A propensity score-matching analysis. Front Neurol 2022; 13:943453. [PMID: 36188388 PMCID: PMC9517937 DOI: 10.3389/fneur.2022.943453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Although acupuncture is widely used as a complementary therapy in the treatment of Bell's palsy (BP) when to initiate acupuncture is still controversial. This study aims to determine the efficacy of the early intervention by acupuncture on BP. Methods We retrospectively gathered clinical data from the Third Affiliated Hospital of SUN-YAT SEN University between 2016 and 2021. We selected newly diagnosed patients with BP who were diagnosed by registered neurologists or acupuncturists formally. The qualified patients were divided into two groups according to whether or not initial acupuncture treatment was given within 7 days from the onset of palsy. Cohorts were balanced using 1:1 propensity score matching (PSM). Cox proportional hazards modeling and Kaplan–Meier analysis were applied to determine the differences between the two groups. The outcome included time to complete recovery of facial function, the rate of complete recovery, and the occurrence of sequelae in 24 weeks. Results A total of 345 patients were eligible for this study and were divided into the manual acupuncture/electroacupuncture (MA/EA) group (n = 76) and the EA group (n = 125). In the propensity score-matched cohort, the time to complete recovery was significantly shorter in the MA/EA group compared with the patients in the EA group (hazard ratio 1.505, 95% CI 1.028–2.404, p <0.05). The MA/EA group had a higher rate of favorable outcomes at 12 weeks than the EA group (93.4 vs. 80.3%, p = 0.032), and the occurrence of sequelae at 24 weeks showed a greater reducing trend in the MA/EA group than the EA group (6.6 vs. 16.4%, p = 0.088). Conclusion Acupuncture intervention at the acute stage of BP could shorten the time to recovery and improve the outcome. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR 2200058060.
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Affiliation(s)
- Lian-Sheng Yang
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Dan-Feng Zhou
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shu-Zhen Zheng
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Bai-Ming Zhao
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huo-Gui Li
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qi-Qing Chen
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yun Zhong
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hong-Zhi Yang
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Kun Zhang
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- *Correspondence: Kun Zhang
| | - Chun-Zhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Chun-Zhi Tang
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Kim TH, Yeo SG, Byun JY. Role of Biomarkers as Prognostic Factors in Acute Peripheral Facial Palsy. Int J Mol Sci 2021; 23:307. [PMID: 35008742 PMCID: PMC8745072 DOI: 10.3390/ijms23010307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 11/25/2022] Open
Abstract
Acute peripheral facial palsy (APFP), including Bell's palsy and Ramsay Hunt syndrome, is a disease that affects daily life through facial motor dysfunction, causing psychological problems. Various tests to evaluate prognosis have been studied; however, there are no validated predictive biomarkers to guide clinical decision making. Therefore, specific biomarkers that respond to treatment are required to understand prognostic outcomes. In this review, we discuss existing literature regarding the role of APFP biomarkers in prognosis and recovery. We searched the PubMed, EMBASE, and Cochrane Library databases for relevant papers. Our screening identified relevant studies and biomarkers correlating with the identification of predictive biomarkers. Only studies published between January 2000 and October 2021 were included. Our search identified 5835 abstracts, of which 35 were selected. All biomarker samples were obtained from blood and were used in the evaluation of disease severity and prognosis associated with recovery. These biomarkers have been effective prognostic or predictive factors under various conditions. Finally, we classified them into five categories. There is no consensus in the literature on the correlation between outcomes and prognostic factors for APFP. Furthermore, the correlation between hematologic laboratory values and APFP prognosis remains unclear. However, it is important to identify new methods for improving the accuracy of facial paralysis prognosis prediction. Therefore, we systematically evaluated prognostic and potentially predictive APFP biomarkers. Unfortunately, a predictive biomarker validating APFP prognosis remains unknown. More prospective studies are required to reveal and identify promising biomarkers providing accurate prognosis.
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Affiliation(s)
| | | | - Jae Yong Byun
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 05278, Korea; (T.H.K.); (S.G.Y.)
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İnan S, Jafarov S. Prognostic role of neutrophil lymphocyte ratio and mean platelet volume in Bell's palsy: Comparison of diabetic and non-diabetic patients. Braz J Otorhinolaryngol 2021; 89:98-103. [PMID: 34895869 PMCID: PMC9874336 DOI: 10.1016/j.bjorl.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/28/2021] [Accepted: 10/19/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES A low Neutrophil Lymphocyte Ratio (NLR) has been shown to be associated with good prognosis in Bell's Palsy (BP). However, the effect of chronic diseases that may affect the NLR, including Diabetes Mellitus (DM), has not been clarified in this context. This study aimed to evaluate the relationship between NLR and Mean Platelet Volume (MPV) in BP according to whether it is accompanied by DM, and their relationship with prognosis. METHODS A prospective observational study was conducted from May 2014 to May 2020 in a tertiary referral center, of all 79 consecutive participants diagnosed with BP in department of otolaryngology and 110 consecutive healthy participants admitted to the check-up unit. Patients diagnosed with BP were divided into two groups according to whether they were diagnosed with DM: diabetic BP patients (DM-BP, n = 33) and non-diabetic BP patients without any chronic disease (nonDM-BP, n = 46). Neutrophil (NEUT) and Lymphocyte (LYM) counts, and Mean Platelet Volume (MPV) were assessed from peripheral blood samples, and the NLR was calculated. Prognosis was evaluated using the House-Brackmann Score (HBS) six months after diagnosis. RESULTS The mean NLR was 2.85 ± 1.85 in BP patients and 1.69 ± 0.65 in the control group. The mean NLR was significantly higher in BP patients than healthy controls (p < 0.001). The mean NLR was 2.58 ± 1.83 in the nonDM-BP group, 3.23 ± 1.83 in the DM-BP group, and 1.69 ± 0.65 in the control group. The NLR was significantly higher in the nonDM-BP and DM-BP groups than in the control group (p < 0.05). The recovery was 90% according to the HBS. The optimal cut-off value was 2.41 (p = 0.5). CONCLUSION The NLR was increased in both diabetic and non-diabetic BP and had similar prognostic value in predicting the HBS before treatment in diabetic and non-diabetic patients with BP. MPV wasn't significantly different in diabetic and non-diabetic BP patients compared with the normal population.
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Islamoglu Y, Celik B, Kiris M. Facial paralysis as the only symptom of COVID-19: A prospective study. Am J Otolaryngol 2021; 42:102956. [PMID: 33592554 PMCID: PMC7972325 DOI: 10.1016/j.amjoto.2021.102956] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/07/2021] [Indexed: 12/02/2022]
Abstract
Purpose Idiopathic facial palsy is called as Bell's palsy and reports showed that facial paralysis increased during COVID-19 pandemic period. There are many reports about the relationship between COVID-19 and facial paralysis but there is no prospective study. SARS-CoV-2 IgG and IgM antibodies increase in COVID-19. Our purpose is to investigate SARS-CoV-2 IgG + IgM antibody in the Bell's palsy. Methods Prospective cross-sectional study was planned. Patients with acute peripheral facial paralysis with no reason and diagnosed as Bell's palsy was included in the study. In order to investigate SARS-CoV-2 in the etiologies of these patients, SARS-CoV-2 IgM + IgG (total) test was studied. SARS-CoV-2 IgG + IgM was measured by using the ADVIA Centaur® test kit. Test reports result in index values and as nonreactive or reactive. The results were analyzed. Results Forty-one patients were included in the study. The average age of the patients was 41,7. 17 (41,4%) were female and 24 (58,6%) were male. 21 patients had left-sided; 20 had right-sided paralysis. SARS-CoV-2 IgG + IgM values were measured two times of the patients. First control was in the first week of facial paralysis, 10 (24,3%) positivity was found. The average index of the positive patients were 6,74 (min.1,39–max.10) in the first control and 9,585 in the second control (min.8,7–max. 10). Conclusion We found that the SARS-CoV-2 IgM + IgG antibody test was positive in 24.3% of the patients with Bell's palsy. The results are higher than the seroprevalence studies conducted in asymptomatic individuals. Facial paralysis could be the only symptom of COVID-19 but further studies must be done.
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Affiliation(s)
- Yuce Islamoglu
- Ankara City Hospital, Department of Otolaryngology Head and Neck Surgery, Ankara, Turkey.
| | - Burak Celik
- Ankara Yıldırım Beyazıt University, Department of Otolaryngology Head and Neck Surgery, Ankara, Turkey
| | - Muzaffer Kiris
- Ankara Yıldırım Beyazıt University, Department of Otolaryngology Head and Neck Surgery, Ankara, Turkey
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Cayir S, Kilicaslan C. Hematologic parameters as predictive markers in pediatric Bell's palsy. Eur Arch Otorhinolaryngol 2020; 278:1265-1269. [PMID: 33159247 DOI: 10.1007/s00405-020-06459-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To analyze various hematological parameters in pediatric population with Bell's palsy (BP) and to determine the most valuable parameter as a prognostic marker. METHODS Fifty-nine patients with BP under 18 years were enrolled, and patients were divided into three groups: recovery group (49 cases), non-recovery group (10 cases) and controls (65 healthy children). Age, white blood cell (WBC), hemoglobin (Hbg), mean platelet volume (MPV), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein-to-albumin ratio (CAR) were determined and compared between groups. Additionally, the receiver operating characteristics (ROC) analysis was carried out, and the most valuable marker to demonstrate the prognosis among these parameters was investigated. RESULTS While mean age was found as 10.69 ± 5.76 years, 28 (47.5%) female and 31 (52.5%) male pediatric patients were determined to be followed up due to BP in our hospital. When such parameters age, mean Hbg, MPV and RDW were examined, no significant difference was detected between groups. However, compared controls with recovery and non-recovery groups, WBC, NLR, PLR and CAR were found to be significantly higher, respectively (p < 0.05). Median CAR and NLR values were found to be significantly higher in non-recovery group, compared to those in recovery group (p = 0.001, p = 0.012, respectively). However, when median WBC and PLR were examined between recovery and non-recovery groups, no significant difference was observed (p > 0.05). CONCLUSION High NLR and CAR values in pediatric BP may be related to poor prognosis in such patients. CAR, however, is a more valuable parameter than NLR in terms of indicating poor prognosis.
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Affiliation(s)
- Serkan Cayir
- Department of Ear Nose and Throat and Head and Neck Surgery, Aksaray Education and Research Hospital, Aksaray University, 68100, Aksaray, Turkey.
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Kim SJ, Lee HY. Hematological Findings in Patients with Acute Peripheral Facial Palsy. J Int Adv Otol 2020; 16:382-386. [PMID: 33136021 DOI: 10.5152/iao.2020.8748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed at evaluating the clinical significance of hematological findings in patients with acute peripheral facial palsy. MATERIALS AND METHODS For this retrospective case series review, 84 patients who visited our university hospital and were diagnosed with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS) between March 2017 and March 2019 were enrolled. We documented their epidemiological details, final diagnoses, House-Brackmann (HB) palsy grades, and pretreatment and day 7 post-hospitalization complete blood counts. The outcome was considered favorable if the HB grade at weeks 10-16 was I or II. We analyzed the hematological findings in terms of diagnosis and the final treatment outcomes. RESULTS A higher pretreatment neutrophil-to-lymphocyte ratio (NLR) and neutrophil count and a lower day-7 lymphocyte count were observed in patients with RHS with unfavorable outcomes. In such patients, moderate positive correlations were observed between the pretreatment white blood cell, neutrophil, and basophil counts; the NLR and basophil-to-lymphocyte ratio; and the initial HB grade. Only the latter was a significant risk factor for a poor treatment outcome. In patients with BP, both the initial HB grade and the pretreatment eosinophil count were included in a regression model predicting prognosis. CONCLUSION Inflammation plays an important role in RHS pathogenesis. Initial RHS severity and the response to corticosteroids may determine the final treatment outcome. However, inflammatory markers do not predict all BP outcomes; BP may be etiologically heterogeneous.
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Affiliation(s)
- Su Jin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Ho Yun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
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Kim DH, Oh JH, Kim J, Cho CH, Lee JH. 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 JOURNAL 2020; 100:720-725. [PMID: 32364446 DOI: 10.1177/0145561320922097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Bell's palsy (BP) is the most frequent cause of unilateral facial paralysis, and inflammation is believed to play an important role in pathogenesis. Due to its rarity, however, no consensus has been reached regarding optimum treatment or factors affecting prognosis. In the present study, treatment outcomes and prognostic factors of BP were investigated in pediatric patients who underwent steroid therapy. The goal was to investigate the relationship between BP and inflammation using multiple inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell distribution width (RDW). MATERIALS AND METHODS In all, 54 patients diagnosed with BP and 39 healthy randomly selected controls were enrolled in this retrospective study. Demographic characteristics and complete blood cell count test results were compared. In addition, prognostic factors were sought by dividing the 54 patients with BP into 2 groups according to the House-Brackmann grading system: low grade BP (grades II and III) and high grade BP (grades IV and V). Serum samples were analyzed retrospectively on initial presentation and 6 months after the symptom begins. Meaningful hematological parameters include NLR, PLR, MPV, and RDW. RESULTS The NLR values in the BP group were significantly higher than in the control group. The NLR value in the 2 groups of patients with BP differed significantly. The mean PLR value in the BP group was higher than in the control group; however, there were no significant differences between the low-grade and high-grade BP groups nor were there any statically significant differences in the other characteristics. CONCLUSION The NLR and PLR values are readily accessible parameters that may be useful prognostic markers in pediatric patients with BP. Further studies are required to confirm these results and their utility in predicting prognosis and treating pediatric patients with BP.
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Affiliation(s)
- Dong Hyun Kim
- Department of Otolaryngology-Head and Neck surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Jae Hwan Oh
- Department of Otolaryngology-Head and Neck surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Junsuk Kim
- Department of Otolaryngology-Head and Neck surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Chang Hyun Cho
- Department of Otolaryngology-Head and Neck surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Ju Hyoung Lee
- Department of Otolaryngology-Head and Neck surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Hematologic Markers of Bell's Palsy: A Meta-analysis. Otol Neurotol 2020; 40:681-687. [PMID: 31083100 DOI: 10.1097/mao.0000000000002166] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Bell's palsy (BP) is the most common cause of unilateral peripheral facial paralysis, and inflammation has been proposed as the main pathological cause. The study aim was to investigate the relationship between hematologic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and BP. DATA SOURCES The following key words were used to search PubMed and Scopus for English language articles: Bell's palsy, facial palsy, facial paresis or facial paralysis, neutrophil, lymphocyte, and platelet. STUDY SELECTION Articles related to BP with NLR or PLR data. DATA EXTRACTION The data included patient profiles, House-Brackmann score, treatment modality, NLR, and PLR. DATA SYNTHESIS Seven articles were selected. A random effect model was used to analyze the aggregated data. Six of these articles that included the NLR and two that included the PLR of BP and control patients were analyzed for the difference between BP and control patients. Three articles that included the NLR of the recovery and nonrecovery groups were analyzed for the relationship between NLR and recovery. CONCLUSIONS The NLR was significantly higher for the BP patients than for the controls. Furthermore, the NLR was significantly lower for the recovery group than for the nonrecovery group. A high NLR was associated with poor prognosis and related to the severity of facial nerve inflammation. There was no significant difference between the PLRs of the BP patients and controls. The NLR, but not the PLR, was found to be a useful prognostic indicator of BP.
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Demir D, Genç S, Güven M, Yılmaz MS, Kara A, Erkorkmaz Ü. Intratympanic Steroid Treatment of Bell's Palsy in Patients with Comorbid Disease: A Preliminary Report. J Int Adv Otol 2020; 16:47-52. [PMID: 31287437 PMCID: PMC7224433 DOI: 10.5152/iao.2019.5415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 02/23/2019] [Accepted: 02/26/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study evaluated the efficacy of intratympanic steroid injection (ITSI)as initial treatment and therecovery speed for Bell's palsy (BP)inpatients with diabetes mellitus (DM)and/or hypertension (HT). MATERIALS AND METHODS In total,90 patients with comorbid diseases diagnosed with BP received either ITSI (study group, n=61) or systemic steroid treatment (SST) (control group, n=29).The facial nerve function was assessed using the House-Brackmann (HB) grading system for up to 6 months or until complete recovery from BP. To investigate a relationship with the complete recovery time from BP, hematologic and baseline characteristic parameters were analyzed. RESULTS The complete recovery rate of the ITSI and SST groups was 47.5% and 44.8% at the 1st month, 70.5% and 89.7% at the 3rd month, and 96.7% and 100% at the 6th month of the study, respectively. Lymphocyte and neutrophil values were significantly associated with the complete recovery time from BP. No major adverse events from ITSI itself were noticed during the procedure and during the follow-up of the treatment. CONCLUSION Both treatment types have no superiorities over each other in initial treatment for BP in patients with comorbid diseases. ITSI is effective and safe and may avoid the unwanted side effects associated with systemic steroids inthese patients.
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Affiliation(s)
- Deniz Demir
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Sena Genç
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Mehmet Güven
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Mahmut Sinan Yılmaz
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ahmet Kara
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ünal Erkorkmaz
- Department of Biostatistics, Sakarya University School of Medicine, Sakarya, Turkey
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Baklacı D, Guler İ, Kuzucu İ, Kum RO, Özcan M. Status of Lactate Dehydrogenase, Neutrophil-lymphocyte Ratio, Mean Platelet Volume, and Platelet-lymphocyte Ratio in Bell's Palsy. Cureus 2020; 12:e7432. [PMID: 32351812 PMCID: PMC7186107 DOI: 10.7759/cureus.7432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective: The inflammatory and vascular disorders have been proposed in the pathogenesis of Bell’s palsy (BP). Several studies investigated the role of inflammation and ischemia in BP using white blood cell (WBC) count and its subtypes. Here, we aimed to investigate lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet-lymphocyte ratio (PLR) in BP. Methods: The study was conducted on 76 patients with BP and 60 healthy controls. The comparison of LDH, NLR, MPV, and PLR was made between groups. The relationships between LDH, NLR, MPV, and PLR were also investigated. Results: The mean LDH concentrations and NLR were significantly high in BP group than in control group (p < 0.01, p < 0.05, respectively). There was no significant difference between groups in MPV and PLR (p = 0.195, p = 0.263, respectively). Conclusion: Our results support the diagnostic value of high LDH concentrations in BP patients. Further studies are needed to investigate the relationship between LDH and the severity and prognosis of BP.
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Affiliation(s)
- Deniz Baklacı
- Otolaryngology, Kahramankazan State Hospital, Ankara, TUR
| | - İsmail Guler
- Otolaryngology, Medipol University School of Medicine, Ankara, TUR
| | - İhsan Kuzucu
- Otolaryngology, Aksaray University Faculty of Medicine, Aksaray, TUR
| | - Rauf Oğuzhan Kum
- Otolaryngology, Ministry of Health Ankara City Hospital, Ankara, TUR
| | - Müge Özcan
- Otolaryngology, Ministry of Health Ankara City Hospital, Ankara, TUR
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Kim SY, Min C, Choi J, Park B, Choi HG. Air pollution by NO 2 is associated with the risk of Bell's palsy: A nested case-controlled study. Sci Rep 2020; 10:4221. [PMID: 32144358 PMCID: PMC7060183 DOI: 10.1038/s41598-020-61232-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 02/20/2020] [Indexed: 11/28/2022] Open
Abstract
This study investigated the relationship of weather and air pollution with the onset of Bell’s palsy. The Korean Health Insurance Review and Assessment Service-National Sample Cohort (HIRA-NSC) data from 2002 through 2013 were used. The 3,935 Bell’s palsy patients were matched with 15,740 control participants. The meteorological data, including daily mean temperature (°C), daily mean highest temperature (°C), daily mean lowest temperature (°C), daily mean temperature difference (°C), relative humidity (%), spot atmospheric pressure (hPa), sulfur dioxide (SO2) (ppm), nitrogen dioxide (NO2) (ppm), ozone (O3) (ppm), carbon monoxide (CO) (ppm), and PM10 (particulate matter ≤ 10 μg/m3) for 60 days, 30 days, 14 days, 7 days, and 3 days prior to the index date were analyzed for Bell’s palsy cases and controls. Conditional logistic regression analysis was used to estimate the odds ratios (ORs) of the association between the meteorological data and Bell’s palsy. The mean NO2 and PM10 concentrations for 60 days were higher, while that of O3 was lower in the Bell’s palsy group than in the control group (both P < 0.001). The Bell’s palsy group showed 16.63-fold higher odds of NO2 for 60 days (0.1 ppm) than the control group (95% CI = 10.18–27.16, P < 0.001). The ORs of PM10, and O3 for 60 days showed inconsistent results according to the included variables. Bell’s palsy was related to high concentrations of NO2.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jay Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea. .,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea. .,Hallym Convergence Research Institute for Environmental Diseases, Anyang, Korea.
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Superior vestibular neuritis: improved detection using FLAIR sequence with delayed enhancement (1 h). Eur Arch Otorhinolaryngol 2019; 276:3309-3316. [DOI: 10.1007/s00405-019-05639-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/06/2019] [Indexed: 10/26/2022]
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17
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Zhang W, Xu L, Luo T, Zhao B, Wu F, Li X. Immune-related gene expression profiles of hypothermia adipocytes: Implications for Bell's palsy. Oral Dis 2019; 25:1652-1663. [PMID: 31127963 DOI: 10.1111/odi.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/03/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify immune-related gene expression profiles of adipocytes under low temperatures with RNA sequencing as a model for Bell's palsy implications. METHODS Adipocytes were harvested from the white adipose tissue of male Sprague-Dawley rats and cultured under different acute-grade cold exposure conditions of 30, 20, and 10°C, and their genomes were sequenced for RNA sequencing analysis. The differentially expressed genes (DEGs) were validated with reverse transcription polymerase chain reaction. RESULTS In total, 55 (35 upregulated and 20 downregulated), 121 (76 upregulated and 45 downregulated), and 92 (64 upregulated and 28 downregulated) DEGs were identified under 30, 20, and 10°C compared with the control, respectively. KEGG and GO analysis revealed that the DEGs were considerably enriched in immune-related pathways (leukocyte transendothelial migration and platelet activation) and infection (bacterial invasion of epithelial cells and Salmonella infection). The levels of key inflammatory chemokines (CSF1, CXCL1, CCL2, and CCL7) were enhanced after cold exposure. CONCLUSION These findings broaden our understanding of the immune responses to cold exposure in adipocytes. The molecular profiles of adipocyte immune function will help clarify the potential mechanism impacting myelin, which might contribute to the development of strategies to control Bell's palsy.
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Affiliation(s)
- Wenjuan Zhang
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Lei Xu
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Tingting Luo
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China.,The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory for Oral Biomedical Engineering of Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Zhao
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Feng Wu
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Xianqi Li
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China.,Department of Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Japan
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Abstract
Bell’s palsy is the most common condition involving a rapid and unilateral onset of peripheral paresis/paralysis of the seventh cranial nerve. It affects 11.5–53.3 per 100,000 individuals a year across different populations. Bell’s palsy is a health issue causing concern and has an extremely negative effect on both patients and their families. Therefore, diagnosis and prompt cause determination are key for early treatment. However, the etiology of Bell’s palsy is unclear, and this affects its treatment. Thus, it is critical to determine the causes of Bell’s palsy so that targeted treatment approaches can be developed and employed. This article reviews the literature on the diagnosis of Bell’s palsy and examines possible etiologies of the disorder. It also suggests that the diagnosis of idiopathic facial palsy is based on exclusion and is most often made based on five factors including anatomical structure, viral infection, ischemia, inflammation, and cold stimulation responsivity.
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Kim HS, Jung J, Dong SH, Kim SH, Jung SY, Yeo SG. Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell's Palsy. Clin Exp Otorhinolaryngol 2018; 12:261-266. [PMID: 30545211 PMCID: PMC6635715 DOI: 10.21053/ceo.2018.01018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/18/2018] [Indexed: 12/29/2022] Open
Abstract
Objectives Factors predictive of the severity of and recovery from Bell’s palsy remain unclear. This study evaluated the association between neutrophil to lymphocyte ratio (NLR) and the severity of and recovery from Bell’s palsy. Methods This retrospective study included 51 patients who were hospitalized with Bell’s palsy from 2015 to 2017. Degree of paralysis was assessed by House-Brackmann (H-B) grade. Patients with H-B grades 2–4 were classified as having mild to moderate palsy and patients with H-B grade 5 or 6 were classified as having severe palsy. Patients were evaluated for obesity, hypertension and diabetes mellitus, and blood tests were performed to determine NLR and platelet to lymphocyte ratio. Patients were treated with steroids and antiviral agents. H-B grade was assessed 1 week, 1 month, and 3 months after treatment. Results NLR was significantly higher in patients with severe than with mild to moderate palsy (P=0.048). Recovery time was significantly longer in patients with high NLR than low NLR (P=0.045). Conclusion Higher NLR in patients with Bell’s palsy was associated with longer recovery time. NLR may be prognostic of recovery time in patients with Bell’s palsy.
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Affiliation(s)
- Hyung-Sik Kim
- Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea
| | - Junyang Jung
- Department of Anatomy and Neurobiology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung Hwa Dong
- Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sang Hoon Kim
- Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea
| | - Su Young Jung
- Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea
| | - Seung Geun Yeo
- Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea
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Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio for the Effusion Viscosity in Otitis Media. J Craniofac Surg 2017; 29:e98. [PMID: 29040145 DOI: 10.1097/scs.0000000000004021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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"Neutrophil to Lymphocyte Ratio as a Predictive Marker of Vestibular Schwannoma Growth. Otology & Neurotology 2016;37: 580-5". Otol Neurotol 2017; 38:305. [PMID: 28067722 DOI: 10.1097/mao.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Sahin C, Varım C. Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, Mean Platelet Volume and Red Cell Distribution Width Measures in Bells Palsy. Open Access Maced J Med Sci 2017; 5:14-18. [PMID: 28293309 PMCID: PMC5320900 DOI: 10.3889/oamjms.2017.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/23/2016] [Accepted: 12/24/2016] [Indexed: 01/01/2023] Open
Abstract
AIM: The purpose of this study was to investigate the usefulness of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW) in the differential diagnosis and follow-up of patients with Bells Palsy. MATERIAL AND METHODS: Twenty-eight patients diagnosed with Bells Palsy and 28 control patients were included in the study. Serum samples were analysed retrospectively on the initial presentation and the seventh day of admission. RESULTS: On admission, the NLR was 1.7±1.2. The mean absolute neutrophil count was 6100 ± 900/mm^3 in Bells Palsy Group. NLR was 0.9 ± 0.2. The mean absolute neutrophil count was 4400 ± 1100/mm^3 in control group. Statistically, significant changes were not observed in NLR, PLR, MPV and RDW measurements in Bells Palsy group between House-Brackman Staging. CONCLUSION: Statistically significant changes in the neutrophil count and NLR were determined in the measurements between Bells Palsy and control group (p = 0.013, p = 0.016 respectively) on admission. A grade of the disease and NLR measurements had no statistically significant connection. RDW value was investigated for the first time in the literature for Bells Palsy patients.
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Affiliation(s)
- Caner Sahin
- Sakarya Akyazi State Hospiatl, ENT Clinic of Sakarya Akyazi State Hospital, Sakarya, Adapazarı, Sakarya 54000, Turkey
| | - Ceyhun Varım
- Sakarya University, Medical Faculty, Internal Medicine, Adapazarı, Sakarya 54000, Turkey
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23
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Letter to the Editor regarding "Predictive value of the neutrophil-to-lymphocyte ratio in patients with deep neck space infection secondary to acute bacterial tonsillitis". Int J Pediatr Otorhinolaryngol 2017; 92:193. [PMID: 26574174 DOI: 10.1016/j.ijporl.2015.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/20/2015] [Indexed: 11/22/2022]
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Lee JS, Hong SK, Kim DH, Lee JH, Lee HJ, Park B, Choi HG, Kong IG, Song HJ, Kim HJ. The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study. Acta Otolaryngol 2017; 137:35-38. [PMID: 27598228 DOI: 10.1080/00016489.2016.1217561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONCLUSION The elevated neutrophil-to-lymphocyte ratio (NLR) value in children with sudden sensorineural hearing loss (SSNHL) would suggest the inflammatory etiology of pediatric SSNHL. The results of this study may suggest NLR value can be used as a useful indicator, which is associated with the disease severity in pediatric SSNHL. OBJECTIVES This study aimed to elucidate any clues of inflammatory etiology, which might be related with the development of pediatric SSNHL, using calculated NLR. METHODS Forty-six patients aged younger than 19 years, who were admitted to the hospital with the diagnosis of SSNHL, were included in the study. Forty-six healthy children were matched as control group according to their propensity score. The complete blood cell count, calculated NLR, platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) were compared. The relationship between NLR and the initial hearing level was also investigated. RESULTS The mean NLR value was 2.86 ± 2.58 in the SSNHL group, whereas the mean NLR value was 1.63 ± 0.87 in the control group. The mean NLR value of the SSNHL children was significantly higher than that of the control group (p = .023). There was a positive correlation between the NLR value and initial hearing level (r = .312, p = .037).
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Ümit EG. Letter to the Editor concerning "New Predictive Parameters of Bell's Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio". Balkan Med J 2016; 33:710-711. [PMID: 27994931 DOI: 10.5152/balkanmedj.2016.150748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 12/04/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Elif Gülsüm Ümit
- Department of Hematology, Trakya University School of Medicine, Edirne, Turkey
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26
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Bakshi SS. "Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy". Otolaryngol Head Neck Surg 2016; 155:1069. [PMID: 27909205 DOI: 10.1177/0194599816667025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Babademez MA, Gul F, Kale H, Muderris T, Bayazit Y, Ergin M, Erel O, Kiris M. Thiol/disulphide homeostasis in Bell's palsy as a novel pathogenetic marker. Clin Otolaryngol 2016; 42:239-244. [PMID: 27383276 DOI: 10.1111/coa.12701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between Bell's palsy and a novel oxidative stress parameter, thiol/disulphide homeostasis. DESIGN A prospective study evaluating oxidative stress in Bell's palsy. SETTING This research took place in the department of Otorhinolaryngology, Ataturk Training and Research Hospital. PARTICIPANTS Totally, 77 patients with Bell's palsy and 38 healthy controls were included in this study. MAIN OUTCOME MEASURES The blood levels of total and native thiol and disulphide activity were assessed, and their levels were compared in the patients and controls. RESULTS There were statistically significant differences between the patients and controls regarding thiol/disulphide parameters. The mean native thiol and total thiol were significantly lower and disulphide levels were higher in the Bell's palsy than controls. On binary logistic regression analysis, the created model showed 45.3% variation. The cut-off value was 18.95 for disulphides. CONCLUSION Native and total thiol levels were low in the Bell's palsy. This metabolic disturbance may have a role in the pathogenesis of Bell's palsy.
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Affiliation(s)
- M A Babademez
- Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - F Gul
- Department of Otorhinolaryngology, Head and Neck Surgery, Bitlis Tatvan State Hospital, Bitlis, Turkey
| | - H Kale
- Department of Otorhinolaryngology, Head and Neck Surgery, Ataturk Training and Research Hospital, Ankara, Turkey
| | - T Muderris
- Department of Otorhinolaryngology, Head and Neck Surgery, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Y Bayazit
- Department of Otorhinolaryngology, Head and Neck Surgery, Medipol University Faculty of Medicine, Istanbul, Turkey
| | - M Ergin
- Department of Clinical Biochemistry, Gaziantep 25 Aralık State Hospital, Gaziantep, Turkey
| | - O Erel
- Department of Clinical Biochemistry, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - M Kiris
- Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Bakshi SS. Commentary to: 'Is neutrophil-lymphocyte ratio associated with the severity of allergic rhinitis in children?' Doi: 10.1007/s00405-015-3819-y. Eur Arch Otorhinolaryngol 2016; 273:3447-8. [PMID: 27020272 DOI: 10.1007/s00405-016-3923-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Satvinder Singh Bakshi
- Department of ENT and Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry, 607402, India. .,, House Number B2, Shree Pushpa Complex, 15th Bharathi Street, Ananda Nagar, Pondicherry, 605009, India.
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Kilicaslan S, Uluyol S, Gur MH, Arslan IB, Yagiz O. Diagnostic and prognostic value of procalcitonin levels in patients with Bell's palsy. Eur Arch Otorhinolaryngol 2016; 273:1615-8. [PMID: 26894418 DOI: 10.1007/s00405-016-3937-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 02/11/2016] [Indexed: 01/03/2023]
Abstract
Inflammation is thought to play an important role in the pathogenesis of Bell's palsy (BP). Procalcitonin (PCT) is currently among the most frequently used proinflammatory biomarkers in clinical practice. In this study, we assessed the serum PCT levels for predicting the severity and prognosis of BP. In total, 32 patients with House-Brackmann (HB) grade II and III BP (low-grade group), 22 patients with HB grade IV and V (high-grade group) and 35 healthy individuals (control group) were included in this prospective study. PCT levels were compared among these three groups at the time of diagnosis. All patients received standard prednisolone and acyclovir treatment. The correlation between PCT levels and recovery was analyzed 3 months after treatment. The PCT levels for control, low-grade and high-grade BP groups were 0.01 ± 0.001, 0.35 ± 0.05, and 0.98 ± 0.41 ng/mL, respectively. The PCT level in low-grade group was significantly higher than that in control group (p < 0.001), and the PCT level in high-grade BP group was significantly higher than that in low-grade group (p = 0.01, p < 0.05). The complete recovery rate was 93.7 % in low-grade and 54.5 % in high-grade BP group (p = 0.015, p < 0.05). There was a strong negative correlation between PCT levels and recovery rates (r = -0.896, p < 0.001). PCT levels were significantly associated with the severity of BP and higher PCT levels were related with poor clinical outcome in terms of recovery. These results support the diagnostic and prognostic significance of PCT in patients with early BP.
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Affiliation(s)
- Saffet Kilicaslan
- Department of Otolaryngology, Van Training and Research Hospital, Van, Turkey.
| | - Sinan Uluyol
- Department of Otolaryngology, Van Training and Research Hospital, Van, Turkey
| | - Mehmet Hafit Gur
- Department of Otolaryngology, Van Training and Research Hospital, Van, Turkey
| | - Ilker Burak Arslan
- Department of Otolaryngology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ozlem Yagiz
- Department of Otolaryngology, Tepecik Training and Research Hospital, Izmir, Turkey
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Eryilmaz A, Basal Y, Tosun A, Kurt Omurlu I, Basak S. The neutrophil to lymphocyte ratios of our pediatric patients with Bell's palsy. Int J Pediatr Otorhinolaryngol 2015; 79:2374-7. [PMID: 26602556 DOI: 10.1016/j.ijporl.2015.10.047] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neutrophil to Lymphocyte Ratio (NLR) is considered to be a reliable indicator in etiological investigation and identification of the disease severity in inflammatory disorders. There are numerous observations or evidences suggesting that Bell's palsy is an inflammatory disorder. OBJECTIVES Our aim was to investigate the presence of any clue which might suggest inflammatory etiology and also the presence of compliance between NLR elevation and inflammation severity in children. METHODS Patients younger than 18 years with Bell's palsy and who had not another inflammatory disorder in addition to Bell's palsy were included. A total of 25 patients and 25 healthy individuals were taken. The patient group and the control group were compared in terms of NLR, neutrophil and lymphocytes. The relationship of NLR with pre-treatment House-Brackmann classification was evaluated. RESULTS The mean age was 9.86±5.07 in the patient group and 9.14±5.94 in the control group. In all members of the patient group, oral prednisolone (1 mg/kg/d) was administered for 7 days. The post-treatment House-Brackmann classification of all patients was determined as grade 1. The average neutrophil values were significantly higher in the patient group. In terms of average lymphocyte values, no statistically significant difference was found. The average NLR value was 1.78 (0.93-4.58) in the pediatric patient group and 1.1 (0.6-2.05) in the control group. NLR was significantly higher in the patient group. NLR and pre-treatment House-Brackmann classification showed no statistically significant correlation (r=0.173, p>0.05). When cut-off value was taken as 3 for NLR, no statistically significant difference was found between groups. CONCLUSIONS High NLR values determined in pediatric patients with Bell's palsy support the inflammatory feature of this disease. NLR is recommended as a supportive parameter in the diagnosis of pediatric patients with Bell's palsy.
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Affiliation(s)
- Aylin Eryilmaz
- Department of Otorhinolaryngology, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey.
| | - Yesim Basal
- Department of Otorhinolaryngology, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Ayse Tosun
- Department of Pediatric Neurology, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Imran Kurt Omurlu
- Department of Biostatistic, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Sema Basak
- Department of Otorhinolaryngology, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
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Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome. The Journal of Laryngology & Otology 2015; 129:1251. [PMID: 26498109 DOI: 10.1017/s0022215115002893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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