Vascular Etiology in Idiopathic Labyrinthitis: Implication of NLR and PLR and White Matter Changes

: Vascular mechanisms have been implicated in idiopathic acute unilateral audiovestibulopathy (iAUAV, also known as labyrinthitis), especially in older patients. We investigated the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and white matter changes in patients with iAUAV/labyrinthitis to determine the potential vascular etiology in this disorder....

Consider vascular risk factors and inflammatory blood markers (NLR, PLR) when evaluating older patients with sudden unexplained hearing and balance loss, but await larger confirmatory studies before changing diagnostic protocols.

If vascular mechanisms are confirmed in a subset of labyrinthitis cases, it could shift management toward cardiovascular risk reduction rather than purely anti-inflammatory or antiviral treatment.

1. 01Study investigates blood vessel–related causes of sudden, unexplained hearing and balance loss (idiopathic labyrinthitis).
2. 02NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) used as inflammatory/vascular markers.
3. 03White matter changes on brain imaging evaluated as additional evidence of vascular etiology.
4. 04Older patient populations appear to be the primary focus, suggesting age-related vascular risk is a key variable.
5. 05Findings may support a vascular subtype within the broader idiopathic labyrinthitis diagnosis.

PMID

42130200

DOI

10.21053/ceo.2026-00063.

Journal

Clinical and Experimental Otorhinolaryngology

Publication type

research_article

Evidence level

4

Population

Patients with idiopathic acute unilateral audiovestibulopathy (labyrinthitis), with focus on older individuals

Intervention

Measurement of NLR, PLR, and white matter changes as vascular etiology markers