title: A novel predictive marker for the viscosity of otitis media with effusion.
abstract: OBJECTIVE
  To evaluate the significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the prediction of the viscosity of otitis media with effusion.
  
  
  METHODS
  This retrospective study was performed on 81 patients who were admitted to the otolaryngology clinic.The patients were divided into two groups according to their effusion type, as serous or mucoid, which was defined intraoperatively after myringotomy. The NLR and PLR were calculated as a simple ratio between the absolute neutrophil/platelet and absolute lymphocyte counts.Tympanostomy tube insertion was performed for all cases.Under direct visualization, the effusion was aspirated and classified as serous or mucous.
  
  
  RESULTS
  We postulated that an NLR value of less than 1.38 may show mucoid effusion and if the PLR value is less than 97.96, the effusion is mucoid.
  
  
  CONCLUSIONS
  We speculate that a useful predictor of viscosity for a middle ear effusion could prevent unnecessary surgeries and additional costs in the treatment of EMO. Additional studies are needed to confirm our results.
authors.affiliation: ENT, Antalya Medical Park Hospital, Antalya, Turkey.
authors.forename: Osman Fatih
authors.initials: OF
authors.lastname: Boztepe
authors.affiliation: Biochemistry, Antalya Medical Park Hospital, Antalya, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Demir
authors.affiliation: Bahçeşehir University, Faculty of Medicine, ENT Department, Ankara Medical Park Hospital, Ankara, Turkey. Electronic address: taylangun@gmail.com.
authors.forename: Taylan
authors.initials: T
authors.lastname: Gün
authors.affiliation: Kahramanmaraş University, Faculty of Medicine, ENT Department, Kahramanmaraş, Turkey.
authors.forename: Nagihan
authors.initials: N
authors.lastname: Bilal
authors.affiliation: ENT, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Nuray Akmeşe
authors.initials: NA
authors.lastname: Ensari
authors.affiliation: Antalya Medical Park Hospital, ENT Department, Antalya, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Doğru
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count / Q000379:methods*; D001792:Blood Platelets / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D009504:Neutrophils / Q000166:cytology; D010034:Otitis Media with Effusion / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D014783:Viscosity
chemical_list: D015415:Biomarkers
keywords: Neutrophil-to-lymphocyte ratio; Otitis media with effusion; Platelet-to-lymphocyte ratio; Viscosity