The predictive effect of neutrophil-lymphocyte and platelet-lymphocyte ratios in the post-operative recurrence of temporomandibular joint ankylosis

BACKGROUND: Reankylosis is a frequent pathology in patients who are operated for post-traumatic temporomandibular joint (TMJ) ankylosis. In the current practice, ankylosing spondylitis attacks are monitored with the increases in neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). In this study, such a relation between TMJ reankylosis and increase in these ratios was evaluated.
METHODS: Patients who were operated between January 2010 and December 2019 for unilateral or bilateral TMJ ankylosis were included in this study. Temporomandibular gap arthroplasty with an interpositional silicone block was performed for each patient by the same operative team. Each patient had standard physiotherapy. All ages and genders were included in the study. Due to the complete blood count differences between children and adults, 18 years of age was used as a cutoff between the groups. A need for reoperation was accepted as reankylosis. The NLR and PLR of children without and with reankylosis and adults without and with reankylosis were compared.
RESULTS: Twenty-nine children and 38 adults were included in the study. Mean age of the children and adults were 10.8 and 37.3 years, respectively. Eleven children and eight adults had reankylosis. In patients with reankylosis, NLR and PLR were high significantly, regardless of age. In children, PLR was significantly higher in reankylosis patients. In adults, NLR was significantly higher in reankylosis patients.
CONCLUSION: PLR and NLR may be utilized for predicting reankylosis, respectively, in children and adults who were operated for ankylosis due to TMJ fractures.

Temporomandibular eklem ankilozunun ameliyat sonrasý nüksünde nötrofil lenfosit ve trombosit lenfosit oranlarýnýn öngörü etkisi

AMAÇ: Ankiloz nüksü, travma sonrasý geliþen temporomandibular eklem (TME) ankilozuna yönelik ameliyat olan hastalarda sýk görülen bir so-rundur. Günümüzde, ankilozan spondilit alevlenmeleri, nötrofil (NLO) ve trombosit (TLO) lenfosit oranlarýndaki artýþlar ile takip edilmektedir. Bu çalýþmada, TME ankiloz nüksü ve bu oranlardaki artýþ arasýnda benzer bir iliþinin olup olmadýðý deðerlendirildi.
GEREÇ VE YÖNTEM: Ocak 2010 ile Aralýk 2019 arasýnda tek veya çift taraflý TME ankilozu nedeniyle ameliyat edilen hastalar çalýþmaya dahil edildi. Her hastaya ayný ekip tarafýndan temporomandibular eklem boþluk artroplastisi ve araya silikon blok yerleþtirilmesi uygulandý. Her hastaya ayný fizyoterapi uygulandý. Çalýþmaya çocuk ve eriþkin hastalar dahil edildi ve cinsiyet ayrýmý yapýlmadý. Çocuk ve eriþkinler arasýnda tam kan sayýmý farký olduðundan 18 yaþ gruplar arasýnda sýnýr olarak belirlendi. Yeniden ameliyat gereksinimi ankiloz nüksü olarak kabul edildi. Ankiloz nüksü olan ve olmayan çocuklarýn NLO ve TLO’larý karþýlaþtýrýldý. Ankiloz nüksü olan ve olmayan eriþkinlerin NLO ve TLO’larý karþýlaþtýrýldý.
BULGULAR: Çalýþmaya 29 çocuk ve 38 eriþkin dahil edildi. Çocuklarýn ortalama yaþý 10.8 iken eriþkinlerin ortalama yaþý 37.2’idi. On bir çocuk ve sekiz eriþkinde ankiloz nüksü saptandý. Yaþtan baðýmsýz olarak, ankiloz nüksü olan olgularýn NLO ve TLO’larý daha yüksekti. Çocuklarda olan nükslerde TLO anlamlý olarak yüksekken eriþkinlerde NLO anlamlý olarak yüksekti.
TARTIÞMA: Temporomandibular eklem kýrýðýna baðlý geliþen ankilozlarýn cerrahisi sonrasý çocuklarda TLO ve eriþkinlerde NLO kullanýlarak ankiloz nüksü öngörüsü yapýlabilir.