title: Predictive value of the neutrophil-to-lymphocyte ratio in patients with deep neck space infection secondary to acute bacterial tonsillitis.
abstract: OBJECTIVE
  The aim of this study was to determine whether the neutrophil-to-lymphocyte ratio (NLR) can be used as a predictor for deep neck space infections (DNSIs) that occur as a complication of acute bacterial tonsillitis in the pediatric population.
  
  
  METHODS
  We evaluated the NLR values of 180 pediatric patients diagnosed with acute bacterial tonsillitis with or without DNSI who presented to the Otolaryngology Department of Marmara University Hospital between 2010 and 2013. In cases in which DNSI was suspected, the patients underwent complete otolaryngological examination and radiological imaging including CT and MRI. NLR was calculated in all the subjects and was compared between the patients with acute bacterial tonsillitis without DNSI and those with DNSI.
  
  
  RESULTS
  With regard to the tonsillitis-related complications, 17 patients had peritonsillar abscess (9.4%); five, parapharyngeal abscess (2.8%); and two, retropharyngeal abscess (1.1%). The mean NLR was significantly higher in the patients of acute bacterial tonsillitis with DNSI (P<0.05). The optimum cut-off value of NLR was determined to be 5.4.
  
  
  CONCLUSIONS
  This study is the first to investigate the relationship between NLR and DNSI as a complication of acute bacterial tonsillitis. The results demonstrated that the NLR value could be a potential laboratory parameter for diagnosing DNSIs.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tekin
authors.initials: T
authors.lastname: Baglam
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey. Electronic address: adembinnet@hotmail.com.
authors.forename: Adem
authors.initials: A
authors.lastname: Binnetoglu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Cemal
authors.initials: AC
authors.lastname: Yumusakhuylu
authors.affiliation: Department of Biochemistry, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
authors.forename: Fethullah
authors.initials: F
authors.lastname: Gerin
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
authors.forename: Berat
authors.initials: B
authors.lastname: Demir
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sari
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001424:Bacterial Infections / Q000097:blood / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count / Q000379:methods; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging / Q000473:pathology; D009504:Neutrophils / Q000166:cytology*; D000039:Peritonsillar Abscess / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D011859:Radiography; D017703:Retropharyngeal Abscess / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D014069:Tonsillitis / Q000097:blood / Q000150:complications*
keywords: Acute bacterial tonsillitis; Deep neck infection; Inflammation; Neutrophil-to-lymphocyte ratio