Otosclerosis associated with higher systemic immune-inflammation index in retrospective case-control study

Photo by Europeana / Unsplash

Frontiers in Medicine Published April 13, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Note that otosclerosis associates with higher SII and lower lymphocytes in this small retrospective cohort.

This retrospective case-control study evaluated 102 patients, comprising 52 individuals with otosclerosis who underwent stapedotomy and 50 control subjects who underwent septoplasty for isolated nasal septal deviation. The primary objective was to assess the association between otosclerosis and systemic inflammatory indices, specifically the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII). Secondary outcomes included individual blood count components such as neutrophil, platelet, and lymphocyte counts.

Analysis revealed that the SII was significantly higher in the otosclerosis group (599.1 ± 154.3) compared to controls (503.5 ± 114.8), with a p-value of 0.041. Multivariable analysis yielded an odds ratio of 1.24 per 100-unit increase (95% CI: 1.00–1.53; p = 0.047). Conversely, lymphocyte counts were significantly lower in the otosclerosis group (2.31 ± 0.65 vs. 2.50 ± 0.84 × 10³/μL; p = 0.019). While the NLR was numerically higher in the otosclerosis group (2.14 ± 0.8 vs. 1.89 ± 0.6), this difference did not reach statistical significance (p = 0.107). No significant differences were observed for neutrophil (p = 0.516) or platelet counts (p = 0.337). ROC analysis indicated moderate discrimination for SII (AUC = 0.658; 95% CI: 0.501–0.815).

Safety data, adverse events, and tolerability were not reported in the study. Key limitations include the retrospective design, borderline statistical significance for some outcomes, and moderate performance of the SII in discrimination. The study setting and follow-up duration were not reported. Funding sources and conflicts of interest were not disclosed. These findings are exploratory and require confirmation in larger, prospective cohorts before clinical application.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

ObjectiveOtosclerosis is a localized metabolic bone disease of the otic capsule with an inflammatory component. This study investigated whether otosclerosis is associated with alterations in systemic inflammatory indices, namely the Neutrophil-to-Lymphocyte Ratio (NLR) and the Systemic Immune-Inflammation Index (SII).Materials and methodsThis retrospective case–control study included 52 patients with otosclerosis who underwent stapedotomy and 50 control subjects who underwent septoplasty for isolated nasal septal deviation between January 1, 2023 and January 1, 2024. Preoperative venous blood samples were obtained within 7 days before surgery, between 08:00 and 10:00 a.m. after overnight fasting. Complete blood counts were analyzed using an automated hematology analyzer (UniCel DxH 800, Beckman Coulter, USA). SII was calculated as (platelet × neutrophil)/lymphocyte, and NLR as neutrophil/lymphocyte. Group comparisons, multivariable logistic regression (adjusted for age and sex), and ROC curve analyses were performed.ResultsSII was significantly higher in the otosclerosis group than in controls (599.1 ± 154.3 vs. 503.5 ± 114.8; p = 0.041). NLR was numerically higher in otosclerosis (2.14 ± 0.8 vs. 1.89 ± 0.6) but did not reach statistical significance (p = 0.107). Individual components showed no significant between-group differences in neutrophil count (4.96 ± 1.53 vs. 4.73 ± 1.99 × 103/μL; p = 0.516) or platelet count (279.22 ± 55.71 vs. 266.63 ± 74.98 × 103/μL; p = 0.337), while lymphocyte count was significantly lower in otosclerosis (2.31 ± 0.65 vs. 2.50 ± 0.84 × 103/μL; p = 0.019). In multivariable analysis, SII (per 100-unit increase) remained independently associated with otosclerosis (OR = 1.24, 95% CI: 1.00–1.53; p = 0.047). ROC analysis demonstrated moderate discrimination for SII (AUC = 0.658, 95% CI: 0.501–0.815).ConclusionSII was independently associated with otosclerosis, suggesting a subtle systemic immune–inflammatory signature. Given the borderline significance and moderate ROC performance, these findings should be interpreted as exploratory and require confirmation in larger prospective cohorts.

Otosclerosis associated with higher systemic immune-inflammation index in retrospective case-control study

Study Details

Intravenous tenecteplase improves functional outcomes but increases hemorrhage risk in non-large vessel occlusion acute ischemic stroke.

Tenecteplase improves stroke recovery but increases bleeding risk in late treatment window

Clinical research that matters. Delivered to your inbox.

Otosclerosis associated with higher systemic immune-inflammation index in retrospective case-control study

Study Details

Intravenous tenecteplase improves functional outcomes but increases hemorrhage risk in non-large vessel occlusion acute ischemic stroke.

Tenecteplase improves stroke recovery but increases bleeding risk in late treatment window

Clinical research that matters. Delivered to your inbox.

Related in Neurology

From Other Specialties