The Role of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Diagnosing Odontogenic and Non-odontogenic Head and Neck Abscesses.

Introduction Head and neck abscesses are categorized as either odontogenic, originating from dental infections, or non-odontogenic, arising from soft tissue inflammation. This article aimed to investigate inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), and compare them against established diagnostic parameters such as white blood cell (WBC) count, neutrophil count (Neu), lymphocyte count (Ly), platelet count (PLT), C-reactive protein (CRP), and procalcitonin (PCT). Material and methods Our retrospective analysis of a prospective study involved 80 patients, including 50 individuals (56% men) with an average age of 41.6±18.18 years diagnosed with odontogenic abscesses and 30 patients (66.7% men) with an average age of 44.53±15.49 years diagnosed with non-odontogenic head and neck abscesses, during the period from July 2021 to June 2022. The complete blood count provided data on WBC, Neu, Ly counts, MPV, and PLT using a 5-diff hematological analyzer. The MPV to PLT index (MPI) was calculated by dividing MPV by PLT, neutrophil-to-lymphocyte ratio (NLR) by dividing Neu by Ly, and platelet-to-white blood cell ratio (PWR) by dividing PLT to WBC. A latex-enhanced immunoturbidimetric assay was used to determine CRP (mg/L) on Cobas 6000 and PCT (ng/mL) on Advia 1800. Results PLT, PCT, and Ly were lower in patients with odontogenic abscesses compared to those with non-odontogenic abscesses (p<0.05), while CRP and Neu were significantly elevated in the odontogenic abscess group (p<0.05). In the non-odontogenic abscess group, men presented higher CRP levels (50.39±64.99 ng/mL versus 9.77±8.36 mg/L), MPI (0.036±0.017 ng/mL versus 0.029±0.01 ng/mL), and NLR (5.6±5.66 versus 3.09±2.2) compared to women (p<0.05). In contrast, women exhibited higher PLT values (390.78±197.129x10/L versus 220.33±55.153x10/L) and PWR (43.88±32.72 versus 23.86±9.34) compared to men (p<0.05). A significant combination of Ly% and Neu% was identified for predicting the MPV value in the non-odontogenic abscess group (R²=0.126, p=0.042), NLR and PWR as a predictor of CRP in both study groups (p<0.05) (R²=0.3 for the non-odontogenic abscess group, R²=0.448 for the odontogenic abscess group), and NLR and PWR as predictors for PCT values in those with non-odontogenic abscesses (R²=0.239, p=0.025). Discussion Despite the expected association between elevated MPV and heightened inflammatory responses, our findings revealed an inverse correlation between MPV and Neu and Ly in patients with non-odontogenic abscesses. This indicates complex interactions in immune responses during inflammation and underscores the need for further investigation to clarify MPV's role across different abscess types. Integrating traditional inflammatory markers such as CRP and PCT with indices such as NLR and MPV can enhance our understanding of inflammatory responses and improve predictions regarding patient outcomes in head and neck abscesses. Conclusion Our study confirms the value of combining traditional inflammatory markers such as CRP and PCT with indices such as NLR and MPV to assess the severity of infections in head and neck abscesses. These biomarkers provide significant insights into inflammatory responses and may improve patient outcome predictions. However, further research with larger, diverse populations is needed to fully integrate these markers into routine clinical practice for better management of such infections.