{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:17:55Z","timestamp":1787735875635,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World j. otorhinolaryngol.-head neck surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic rhinosinusitis (CRS) is a prolonged inflammatory condition of the nasal and paranasal sinuses that significantly affects quality of life. This study examines the relationship between CRS severity (based on Lund\u2010Mackay [LM] scores), osteitis, and systemic inflammatory markers, including neutrophil\u2010to\u2010lymphocyte ratio (NLR), platelet\u2010to\u2010lymphocyte ratio (PLR), monocyte\u2010to\u2010lymphocyte ratio (MLR), basophil\u2010to\u2010lymphocyte ratio (BLR), eosinophil\u2010to\u2010lymphocyte ratio (ELR), and the systemic immune inflammation index (SII).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 208 CRS patients (with or without nasal polyps) who underwent FESS at Jordan University Hospital was performed. Patients were stratified by LM scores into three groups from lowest to highest scores. Inflammatory markers were compared using non\u2010parametric statistical tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ELR showed the strongest correlation with radiological CRS severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) overall. BLR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0043) and MLR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0199) also showed significant differences, while NLR and PLR did not. ELR was significantly higher in group 3 with the highest Lund\u2013MacKay score for CRS and posterior ethmoid and sphenoid sinus involvement. In patients without nasal polyposis, all markers except MLR showed significant differences with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ELR is a promising, non\u2010invasive biomarker for assessing CRS severity, especially in patients without nasal polyps. It may help evaluate disease burden when imaging is unavailable, offering a cost\u2010effective tool in clinical practice and a valuable addition to the current management protocol for chronic rhinosinusitis treatment guidelines in low\u2010 and middle\u2010income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjo2.70141","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:22:13Z","timestamp":1787732533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune Clues to Sinus Blues: Linking Biomarkers to Radiologic Score of Rhinosinusitis"],"prefix":"10.1002","author":[{"given":"Lubna","family":"Khreesha","sequence":"first","affiliation":[{"name":"Department of Special Surgery, School of Medicine The University of Jordan &amp; Jordan University Hospital Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9759-4594","authenticated-orcid":false,"given":"Amer","family":"Sawalha","sequence":"additional","affiliation":[{"name":"Department of Special Surgery, School of Medicine The University of Jordan &amp; Jordan University Hospital Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Darweesh","sequence":"additional","affiliation":[{"name":"Department of Special Surgery, School of Medicine The University of Jordan &amp; Jordan University Hospital Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qusai","family":"Elfadel","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alzoubi","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif","family":"Alhawadi","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Alsawair","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fares","family":"Habboub","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Alsmady","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Aljarboa","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashim","family":"Alhammouri","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan Amman Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10061362"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5742\/MEWFM.2023.95251556"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.05.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.02.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3598-5"},{"issue":"3","key":"e_1_2_12_7_1","first-page":"181","article-title":"Nasal\u2010Sinus Polyposis: Clinical\u2010Cytological Grading and Prognostic Index of Relapse","volume":"23","author":"Gelardi M.","year":"2009","journal-title":"Journal of Biological Regulators and Homeostatic Agents"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.04.005"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2018.04.013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502750"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino12.022"},{"issue":"4","key":"e_1_2_12_12_1","first-page":"183","article-title":"Staging in Rhinosinusitus","volume":"31","author":"Lund V. 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