Systemic inflammatory markers in vestibular neuritis and BPPV: A single-center retrospective study

Aims: This study aimed to compare systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), derived NLR (dNLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), in patients with vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) and to evaluate their potential role in differential diagnosis.Methods: In this retrospective study, 109 patients diagnosed with VN (n=52) or BPPV (n=57) at Kastamonu Training and Research Hospital were included between January 2024 and December 2024. Demographic characteristics, clinical data, and laboratory parameters (leukocyte, neutrophil, lymphocyte, monocyte, platelet, CRP, and albumin levels) were recorded. NLR, dNLR, MLR, PLR, SII [(platelet × neutrophil)/lymphocyte], and SIRI [(neutrophil × monocyte)/lymphocyte] were calculated.Results: The two groups were similar regarding age and sex distribution; however, bilateral involvement was significantly more common in the BPPV group (p=0.004). The VN group showed significantly higher leukocyte (p=0.027) and neutrophil (p=0.004) counts and significantly lower albumin levels (p=0.001). Among inflammatory markers, NLR (p=0.012), SII (p=0.023) and SIRI (p=0.035) were found to be significantly higher in VN patients than in BPPV patients.Conclusion: The significant increase in NLR, SII, and SIRI levels in VN patients compared with BPPV patients suggests a more prominent role of inflammatory mechanisms in the pathogenesis of vestibular neuritis. These readily available and inexpensive biomarkers may serve as supportive tools in the differential diagnosis of peripheral vertigo in clinical practice.