The Role of Neutrophil Lymphocyte Ratio (NLR) as a Predictor in Severity Chronic Suppurative Otitis Media (CSOM)

Background: Tissue damage due to microbial invasion in CSOM cases causes inflammatory mechanisms related to specific and non-specific immunity. Neutrophil Lymphocyte Ratio (NLR) is an inflammatory marker in CSOM as a prognostic indicator of the disease.  Objective: To determine the role of NLR as determinant inflammatory parameters of CSOM in predicting disease prognosis.  Methods: Analytical observational study with cross sectional design. Sample collection was conducted December 2022-March 2023. There were safe type dry phase CSOM, safe type active phase and dangerous type. The safe type active phase CSOM and dangerous type were given topical antibiotics for 2 weeks. Complete blood Count were repeated to assess NLR after 2 weeks in all types of CSOM. Data analysis used the Kruskal-Wallis alternative test and Spearman rank correlation.  Results: A total of 27 samples involved men (55.6%) and women (44.4%). Based on CSOM type, there were 40.8% of safe type dry phase CSOM, 29.6% safe type active phase and 29.6% dangerous type. The average of NLR value were found significantly different both the beginning (p-value=0.004) and the end (p-value=0.010). Comparison of three types of CSOM in the beginning and the end showed significant decrease (p-value <0.05).  Conclusion: NLR could not be used as a prognostic indicator in the three types of CSOM, because it is included in the very weak category.