Abstract
INTRODUCTION: The systemic immune-inflammatory index (SII) is a biomarker derived from neutrophil, lymphocyte, and platelet counts obtained from a complete blood count. It has shown diagnostic and prognostic significance in various diseases. In chronic otitis media (COM), differentiation is essential preoperatively to determine the appropriate treatment. Hence, the purpose of this study was to assess the predictive value of inflammatory markers in differentiating mucosal and squamosal disease. OBJECTIVE: To evaluate the association of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in the differentiation of chronic otitis media. METHODS: This was a prospective observational analytical study conducted from July 16, 2024, to July 17, 2025, in 100 cases of chronic otitis media. A detailed history was taken, and ear examination, hearing evaluation, and blood sample collection were performed to assess the complete blood count. The numbers of neutrophils, lymphocytes, and platelets were recorded, and NLR, PLR, and SII were then calculated in the two groups. RESULTS: Neutrophil and lymphocyte counts were higher in group one compared to group two, whereas the platelet count was higher in group two compared to group one. NLR was elevated in group two compared to group one. NLR, PLR, and SII were all elevated in group two compared to group one, with a statistically significant p-value of <0.001. CONCLUSION: SII holds significant potential in differentiating between mucosal and squamosal types of chronic otitis media. As a simple, cost-effective, and easily obtainable parameter, SII demonstrated superior diagnostic performance compared to NLR and PLR.