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Labyrinthitis

  • Definition

    Labyrinthitis is swelling and irritation in the inner ear. It occurs in the labyrinth of the ear, usually effecting the nerve. This is a system of cavities and canals. They effect hearing, balance, and eye movement.
    Labyrinthitis
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    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Labyrinthitis is caused by damage or impairment of the labyrinth part of the cochlea from:
    • Infection
    • Trauma
    • Inflammation
    • Drugs
  • Risk Factors

    Factors that may increase your chances of labyrinthitis include:
    • Current or recent viral infection, especially a respiratory infection
    • Allergies
    • Smoking
    • Drinking too much alcohol
    • Stress
    • Head injury
    • Disease of blood vessels
    • Autoimmune disease
    • Side effects of drugs, including:
      • Certain antibiotics
      • Aspirin
      • Quinine—may be used for malaria treatment
  • Symptoms

    The symptoms can range from mild to severe and last for days or many weeks. Symptoms are usually temporary, but rarely, can become permanent.
    The most common symptoms are:
    • A spinning sensation
    • Lightheadedness
    • Balance problems
    Other symptoms may include:
    • Fatigue
    • Nausea and vomiting
    • Hearing loss
    • Involuntary eye movement
    • Ringing in the ear
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. You may also need an ear and/or a neurological exam.
    This can be done with:
    • Maneuvers for evaluating for other causes of lightheadedness
    • Hearing tests
    Images help evaluate the ears or other structues. This can be done with:
    Your eyes may also be tested. This can be done with an electronystagmogram.
  • Treatment

    Treatment may include:
    Medications
    Medication to control the symptoms, including:
    • Antiemetics—to control nausea and vomiting
    • Vestibular suppressants—to limit vertigo
    • Steroids (in limited situations) or nonsteroidal anti-inflammatories—to help control inflammation
    • Antibiotics—to treat a bacterial infection
    • Anti-viral drugs—to treat certain viruses, such as herpes
    Note: Without antibiotic treatment, labyrinthitis caused by a bacterial infection can lead to permanent hearing loss or balance problems.
    Self-care Measures
    Some steps to help you manage your symptoms include:
    • Rest by lying still with your eyes closed in a darkened room during acute attacks.
    • Avoid movement, especially sudden movement, as much as possible.
    • Avoid reading.
    • Resume normal activities gradually after the symptoms have cleared.
    Vestibular Exercises (Vestibular Rehabilitation)
    Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without the sensation of spinning. You may work with a physical therapist to learn these.
    Emergency Treatment
    In some cases, nausea and vomiting cannot be controlled. This can result in severe dehydration. You may need hospitalization to receive fluids and nutrients through an IV. You may also need antiemetic medication.
    Surgery
    Rarely, labyrinthitis may be caused by a break in the membranes between the outer and inner ear. Surgery to repair the break may be required. If a tumor is causing the condition, surgery may also be needed.
  • Prevention

    To help reduce your chances of labyrinthitis:
    • Seek prompt treatment for any ear problems or infection.
    • Avoid head injury by wearing seat belts and safety helmets.
    • Ask your doctor about side effects of any medications you are taking.
    • Avoid drinking excess alcohol.
  • RESOURCES

    National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov

    Vestibular Disorders Association http://www.vestibular.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Healthy Alberta http://www.healthyalberta.com

    References

    Infections of the inner ear. Vestibular Disorders Association website. Available at: http://vestibular.org/labyrinthitis-and-vestibular-neuritis. Accessed August 4, 2015.

    Labyrinthitis. American Association of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/labyrinthitis.html. Updated April 2014. Accessed August 4, 2015.

    Labyrinthitis. Johns Hopkins Medical Center website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/specialty%5Fareas/vestibular/conditions/labyrinthitis.html. Accessed August 4, 2015.

    12/3/2010 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.

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