Predictive value of neutrophil to lymphocyte ratio in first-time and recurrent idiopathic sudden sensorineural hearing loss

Objective: To determine if the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with recurrent idiopathic sudden sensorineural hearing loss (ISSNHL) differ from those in healthy people and non-recurrent ISSNHL patients. Methods: A retrospective review of 16 patients with recurrent ISSNHL was performed with strict exclusion criteria. Independent variables were NLR and PLR, which yielded four groups (control, non-recurrent, recurrent-first attack, and recurrent-second attack groups). Results: Compared with the control group, non-recurrent and recurrent attack groups showed significantly higher NLR values (p < 0.001, respectively). The NLR (odds ratio [OR] 2.178, 95% confidence interval [CI] 1.587-2.988; p < 0.001) and PLR (OR, 1.013, 95% CI, 1.006-1.020; p < 0.001) were found to be independent risk factors only between the control and recurrent-first attack groups. Conclusion: Evidence of increased NLR and PLR is shown in recurrent ISSNHL and non-recurrent ISSNHL, and these increased levels are shown in the second attack of recurrent ISSNHL. Clinicians are advised to monitor the NLR and PLR at the clinic to predict recurrent ISSNHL even after hearing is restored.