This retrospective study aims to compare the effects of low-flow and high-flow anesthesia techniques on intraoperative hemodynamics, neutrophil-to-lymphocyte ratio (NLR), and postoperative outcomes in patients undergoing tympanoplasty or myringoplasty. The data were collected from medical records of patients who underwent ear surgery between [September 1, 2022] and [April 1, 2023]. The study seeks to evaluate whether the choice of anesthetic flow rate has a significant impact on inflammatory response and recovery.

This study investigates the influence of anesthetic gas flow rates on systemic inflammation and hemodynamic stability in middle ear surgeries. While low-flow anesthesia is associated with reduced environmental exposure and cost-effectiveness, its impact on inflammatory markers and recovery outcomes remains less clearly defined. The neutrophil-to-lymphocyte ratio (NLR) is used as a readily available, cost-effective biomarker of systemic inflammation. This study retrospectively analyzes perioperative data from patients who underwent tympanoplasty or myringoplasty, comparing NLR levels, intraoperative vital signs, and postoperative recovery parameters between low-flow and high-flow anesthesia groups. The results may contribute to optimizing anesthetic strategies in otologic surgeries, with emphasis on inflammation modulation and patient safety.

Inclusion Criteria:

• Adults aged between 18 and 75 years
• American Society of Anesthesiologists (ASA) physical status classification I to III
• Body Mass Index (BMI) between 18.5 and 29.9 kg/m²

Exclusion Criteria:

• Age below 18 or above 75 years
• Incomplete or missing clinical data
• BMI less than 18.5 kg/m² or greater than 29.9 kg/m²
• Presence of neurological disorders
• History of renal or hepatic failure

This retrospective study evaluated patients who underwent tympanoplasty or myringoplasty surgery at the operating rooms of Karadeniz Technical University Faculty of Medicine between September 1, 2022, and April 1, 2023. Participants were excluded based on the following criteria: age under 18 or over 75 years, incomplete clinical data, body mass index (BMI) <18.5 kg/m² or >29.9 kg/m², presence of neurological disorders, and a history of renal or hepatic failure. A total of 59 patients aged between 18 and 75 years, with ASA (American Society of Anesthesiologists) physical status scores of I-III and BMI values between 18.5 and 29.9 kg/m², were initially included in the study. Following the exclusion of nine patients with missing data, the final study population consisted of 50 individuals.