Lymphocyte-to-monocyte ratio as a clinical predictor in sudden sensorineural hearing loss

• SII biomarkers are important follow-up parameters in patients with SSNHL. • NLR, PLR, LMR, and SII can serve as vital clinical indicators for SSNHL progression. • LMR emerges as a promising new marker for predicting patient recovery prognosis. This study evaluates the prognostic significance of systemic inflammatory markers ‒ NLR, LMR, PLR, and SII ‒ in patients with SSNHL. This retrospective study included 120 patients diagnosed with SSNHL at the Otolaryngology Department of Hospital. Medical records from both SSNHL and healthy control groups were reviewed to collect demographic data, pure tone audiometry results, and routine blood parameters. Hearing recovery was assessed at baseline and after two months using Siegel's criteria, and patients were categorized as either recovered (complete, partial, or slight recovery) or unrecovered. Compared to controls, SSNHL patients showed significantly elevated neutrophil counts, platelet levels, NLR, PLR, and SII values. Statistically significant differences were observed between recovered and unrecovered groups in neutrophil count (p = 0.021), lymphocyte count (p = 0.001), PDW (p = 0.042), NLR (p = 0.001), PLR (p = 0.001), LMR (p = 0.001), and SII (p = 0.001). Logistic regression analysis identified low LMR as a significant independent predictor of poor prognosis (R² = 0.271). Elevated NLR, PLR, and SII values may reflect inflammatory processes and microvascular dysfunction in SSNHL. Among these, LMR emerged as a novel and potentially valuable prognostic biomarker for predicting treatment outcomes. 3.