Significance of systemic immune-inflammation and inflammatory response indices in vestibular neuritis

Abstract

Introduction: This study investigated the relationship between vestibular neuritis and various systemic inflammatory indices-namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) and the clinical severity of vestibular neuritis. Methods: A total of 79 individuals were included: 41 patients with vestibular neuritis and 38 healthy controls. Systemic inflammatory parameters were calculated from complete blood count results, and their associations with disease severity-classified as mild (<= 4 days of nystagmus) or severe (> 4 days of nystagmus)-were analysed. Results: NLR, SII and SIRI were significantly higher in the severe vestibular neuritis group compared to controls (p = 0.032, p = 0.019 and p = 0.042, respectively), while the mild group showed no significant difference relative to either controls or the severe group. SII demonstrated the highest predictive value for severe vestibular neuritis (AUC = 0.66), showing superior discriminative performance compared with NLR and SIRI. Conclusion: Although the pathogenesis of vestibular neuritis remains unclear, the elevation of NLR, SII and SIRI in more severe cases suggests an inflammatory involvement. Their association with severe disease may support future research into whether these markers could help identify patients who are more likely to benefit from anti-inflammatory treatment strategies. However, further prospective studies are needed to clarify the clinical relevance of these findings.