Almutairi Amani Abdullah, Aljabr Ibrahim K, Alsindi Zahra Saleh, Alkhawajah Amnah Ali, Aljasem Jinan Mohammed, Alzahrani Mohammed Mousa, Almaqhawi Abdullah
College of Medicine, King Faisal University, Al Hofuf P.O. Box 400, Saudi Arabia.
Division of ENT, Departments of Surgery, College of Medicine, King Faisal University, Al Hofuf P.O. Box 400, Saudi Arabia.
Medicina (Kaunas). 2025 Aug 25;61(9):1520. doi: 10.3390/medicina61091520.
: 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. : 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 ( = 42), mucoid OME ( = 78), and non-effusion ( = 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 < 0.05. : Mucoid OME patients exhibited significantly elevated neutrophil counts, platelet counts, eosinophils, NLR, and SII compared to those in serous OME and non-effusion groups ( < 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 ( = 0.008; OR=15.97) but resolving by 1 month. Preoperative neutrophil count independently predicted delayed hearing recovery ( = 0.021). : 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.
中耳积液（OME）常与阻塞性腺样体肥大（OAH）相关，是儿童听力损失的主要原因。临床上区分积液类型（浆液性与黏液性）以及预测术后听力恢复是尚未解决的挑战。本研究评估了术前血液炎症标志物在预测腺样体切除术联合鼓膜置管（TT）术后积液特征和短期听力结果方面的效用。
在这项回顾性队列研究中，2024年232名12岁以下接受腺样体切除术（有或无TT置入）的儿童被分为浆液性OME组（n = 42）、黏液性OME组（n = 78）和无积液组（n = 112）。术前血液样本分析评估了中性粒细胞、淋巴细胞、嗜酸性粒细胞、嗜碱性粒细胞和血小板计数，以及衍生指标，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、嗜酸性粒细胞与嗜碱性粒细胞比值（EBR）、平均血小板体积（MPV）和全身免疫炎症指数（SII）。在术后2周和1个月评估听力。统计分析使用SPSS v.28，显著性设定为P < 0.05。
与浆液性OME组和无积液组相比，黏液性OME患者的中性粒细胞计数、血小板计数、嗜酸性粒细胞、NLR和SII显著升高（P < 0.05）。所有浆液性OME儿童在首次随访时听力均恢复正常，而15.4%的黏液性OME病例在2周后仍有短暂轻度听力损失持续存在（P = 0.008；OR = 15.97），但在1个月时恢复。术前中性粒细胞计数可独立预测听力恢复延迟（P = 0.021）。
全身炎症标志物，特别是中性粒细胞计数、NLR和SII，可有效区分黏液性OME与其他积液类型，并与短期听力恢复相关。中性粒细胞计数可作为手术规划和患者咨询的预后工具。有必要进行前瞻性研究以在更广泛的儿科人群中验证这些发现。
