Ramazan ÖÇAL, Selda KARGIN KAYTEZ, Behiye AKÇAALAN BAYRAM, Mustafa İBAS, Hatice ÇELİK

BELL PARALİZİ OLAN HASTALARDA PDW, RDW VE MPV GİBİ BELİRTEÇLERİN PREDİKTİF DEĞERLERİ İLE BU DEĞERLERİN NLR VE PLR İLE KARŞILAŞTIRILMASI

Amaç: İnflamasyon temeline dayandırılan Bell paralizide NLR(nötrofil-lenfosit oranı), PLR(platelet-lenfosit oranı), MPV(ortalama platelet hacmi), RDW(kırmızı hücre dağılım genişliği) ve PDW(platelet dağılım genişliği) değerlerinin prognostik önemlerinin ve eğer varsa birbirlerine üstünlüklerinin olup olmadığının belirlenmesidir Materyal Metod: Kliniğimize başvuran ve Bell paralizi tanısı konan 52 hastanın ve rutin sağlık taraması için polikliniğe başvuran ve hasta grubu ile cinsiyet açısından benzer 52 bireyden oluşan kontrol grubunun dosyaları retrospektif olarak incelenerek gerçekleştirildi. Kliniğimizde hastaların fasiyal paralizilerinin dereceleri iki ayrı Kulak Burun boğaz uzmanı tarafından House-Brackmann sınıflamasına göre yapılmaktadır. Klinik olarak bütün hastalara standart tedavi uygulanmaktadır. Travma, Ramsey-Hunt sendromu, akut veya kronik otitis media ve tümöre bağlı fasiyal paralizisi olanlar çalışma dışı bırakıldı. Hastaların tam kan sayımı incelemesinden PDW, RDW, MPV değerleri bakılarak; NLR ve PLR ise hesaplanarak tedavi ve kontrol grubu ile tedaviye yanıt veren ve vermeyen gruplar arasında karşılaştırması yapılmıştır. Bulgular: Hasta grubunda ortalama yaş 53.38± 8.31 iken, kontrol grubunda 36.50 ± 11.34 idi. Ortalama lenfosit düzeyi hasta grubunda 2.83±1.13 bulunurken, kontrol grubunda 2.25±0.65 olarak bulundu ve iki grup arasında istatistiksel olarak anlamlı fark izlendi (p=0.002). MPV, RDW, PDW değerleri açısından hasta grubu ve kontrol grubu arasında arasında istatistiksel olarak anlamlı fark izlenmedi. Bu parametrelerin başvuru anındaki değerlerinin prognostik önemi açısından bakıldığında tedaviye yanıt veren ve vermeyen gruplar arasında da istatistiksel olarak anlamlı fark görülmedi. Son olarak hasta grubunda NLR 1.85 ± 0.80, kontrol grubunda 2.07 ± 0.85, yine hasta grubunda PLR 109.91 ± 39.32, kontrol grubunda 124.19 ± 40.25 izlendi ve her 2 parametre açısından da hasta ve kontrol grubu ile tedaviye yanıt veren ve vermeyen gruplar arasında istatistiksel anlamlı fark gözlenmedi. Sonuç: İnflamatuar parametreler Bell paralizide kesin parognostik belirteç değildir ancak literatüre bakıldığında bazılarının mikrovasküler hasar ve artmış inflamasyonla ilişkili olduğu söylenebilir. Dolayısıyla bu hastalarda hastalığın patogenezinin yapılacak çalışmalarla daha iyi ortaya konması ve prognozu belirleyebilecek farklı parametrelerin araştırılmasına ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

Fasiyal paralizi, inflamasyon, prognoz, evre

ABSTRACT Objective: The aim of the study is to determine the prognostic significance of NLR (neutrophil-lymphocyte ratio), PLR (platelet-lymphocyte ratio), MPV (mean platelet volume), RDW (red cell distribution) and PDW (platelet distribution width) values in Bell Paralysis(BP), a disease in which inflammatory processes are blamed in the pathogenesis, and whether these values have superiorities over each other. Material and Methods: The study was carried out by retrospectively examining the files of 52 patients who were admitted to our clinic and diagnosed with BP (patient group) and 52 other control patients who were admitted to the outpatient clinic for routine health screening (control group). In our clinic, the evaluation of these patients is done in line with the House-Brackmann classification, by two different otorhinolaryngologists. All patients receive the same standard treatment. Those with trauma, Ramsey-Hunt syndrome, acute or chronic otitis media and facial paralysis due to tumor were excluded from the study. PDW, RDW and MPV values were obtained by the full blood count test; NLR and PLR values were obtained by calculation. All stated parameters were then compared. Results: While the mean age was 53.38 ± 8.31 in the patient group, it was 36.50 ± 11.34 in the control group. While the mean lymphocyte level was 2.83 ± 1.13 in the patient group, it was 2.25 ± 0.65 in the control group, and a statistically significant difference was observed between the two groups (p = 0.002). There was no statistically significant difference between the patient group and the control group in terms of MPV, RDW, PDW values and between the groups in terms of response to treatment. Finally, the NLR was 1.85 ± 0.80 in the patient group, 2.07 ± 0.85 in the control group, the PLR was 109.91 ± 39.32 in the patient group, and 124.19 ± 40.25 in the control group, and no statistically significant difference was observed neither between the patient and control groups nor the treatment responsive and unresponsive patient groups in terms of both parameters. Conclusion: Inflammatory parameters are not independent prognostic factors in BP however according to the literature, some may be associated with microvascular damage and increased inflammation. There is a need to reveal the pathogenesis of the disease better with future studies and to investigate different parameters that can determine the prognosis

Keywords:

Facial paralysis, inflammation, prognosis, grade,

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