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.

Background: Safranal, a pharmacologically active and potent phytochemical, may exhibit significant antioxidant and anti-inflammatory activity in an acute bacterial rhinosinusitis. Objectives: This study aimed to investigate the efficacy of safranal, a phytochemical with known antioxidant, antibacterial, and anti-inflammatory properties, in an experimentally induced model of acute bacterial rhinosinusitis in rats. Methods: A total of 35 male Wistar rats were randomly divided into five groups: a healthy control group, a rhinosinusitis group induced by Staphylococcus aureus, a cefazolin-treated group, and two safranal-treated groups receiving 100 mg/kg and 200 mg/kg doses, respectively. Rhinosinusitis was induced by intranasal instillation of S. aureus, and treatments were administered for 7 days. Biochemical markers of oxidative stress (SOD, MDA, GSH) and inflammatory cytokines (TNF-α, IL-1β, IL-6) were analysed. Gene expression levels of NF-κB, MMP2, MMP9, and TIMP1 were assessed by qRT-PCR. Immunohistochemistry for PARP1 and PARP2 was performed for histopathological evaluation. Results: The S. aureus-induced rhinosinusitis group exhibited significant oxidative stress and inflammation, as evidenced by decreased SOD and GSH levels, elevated MDA, and increased TNF-α, IL-1β, and IL-6 levels. Safranal treatment, particularly at the high dose (200 mg/kg), significantly restored antioxidant levels, reduced inflammatory cytokines, and suppressed NF-κB, MMPs, and PARP1/2 expression in nasal tissues. Histopathological findings corroborated these results, showing decreased PARP1 and PARP2 immunoreactivity in safranal-treated groups. Conclusion: This study provides compelling evidence that safranal, particularly at a high dose of 200 mg/kg, exhibits significant antioxidant and anti-inflammatory activity in an experimental model of acute bacterial rhinosinusitis. These findings suggest that safranal may be a promising plant-derived alternative for managing rhinosinusitis and reducing antibiotic dependency.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease in which identifying simple biomarkers reflecting disease severity remains challenging. This study aimed to evaluate the relationship between systemic inflammatory indices and radiological disease severity assessed by the Lund–Mackay (LM) score. This retrospective study included 90 adult patients with CRSwNP who underwent endoscopic sinus surgery. Preoperative computed tomography findings were scored using the LM system, and systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-monocyte ratio (NMR), systemic immune-inflammatory index (SII), systemic inflammation response index (SIRI), and eosinophil/leukocyte ratio, were calculated from complete blood count parameters. Spearman correlation and univariate logistic regression analyses were performed. ELR (r = 0.49, p < 0.001) and eosinophil/leukocyte ratio (r = 0.46, p < 0.001) showed moderate positive correlations with LM score, whereas other indices were not significantly associated. In logistic regression analysis, both ELR (OR = 5.44 × 10⁴, p < 0.001) and eosinophil/leukocyte ratio (OR = 4.99 × 10¹², p = 0.001) were significantly associated with high disease burden (LM ≥ 15). These findings suggest that eosinophil-based inflammatory indices may better reflect radiological disease severity in CRSwNP compared to traditional systemic inflammatory markers.