Dear Sirs,

We thank Varol and Ozaydin for their valuable comments. In our study, we investigated the relation of mean platelet volume and sudden SNHL, and found elevated mean platelet volume in patients with sudden SNHL, compared with controls.Reference Sagit, Kavugudurmaz, Guler and Somdas¹

In their letter, Varol and Ozaydin mention that obesity, smoking, coronary artery disease, metabolic syndrome, statin use and atrial fibrillation might have an impact on mean platelet volume.Reference Vizioli, Muscari and Muscari^2, Reference Varol, Icli, Kocyigit, Erdogan, Ozaydin and Dogan³ However, as stated in the methods section of our paper, patients with coronary artery disease and hypercholesterolaemia were not included in our study. We have subsequently extracted data from our patient database regarding body mass index (BMI) and smoking status, for all patients and controls enrolled in the study, and have found that these two groups had similar BMI (mean ± standard deviation, 27.4 ± 1.6 and 27.7 ± 1.4, respectively; p = 0.453) and smoking status (a total of 3 and 2 smokers, respectively; p = 0.641). Likewise, we have identified no patients with atrial fibrillation in either group.

Varol and Ozaydin also mention the possible effect of hyperglycaemia on our mean platelet volume results. We have subsequently performed linear regression analysis to address the impact of blood glucose level on mean platelet volume, and have found that mean platelet volume was not significantly associated with blood glucose level in patients with sudden SNHL (β coefficient = −0.063; p = 0.756). Varol et al. state that some of our patients would have been pre-diabetic, because glucose levels were higher in the patient group than the control group. We were rigorous in our identification of diabetes in our study population. The higher glucose levels observed in our patients (compared with controls) were probably associated with the acute stress caused by patients' sudden hearing loss.