Labyrinthitis

  • Definition

    Labyrinthitis is swelling and irritation in the inner ear. It occurs in the labyrinth of the ear. This is a system of cavities and canals. They affect hearing, balance, and eye movement.
    Labyrinthitis
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  • 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, to help control inflammation
    • Antibiotics—to treat a bacterial infection
    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

    Dizziness - differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 16, 2011. Accessed August 14, 2014.

    Infections of the inner ear. Vestibular Disorders Association website. Available at: http://vestibular.org/labyrinthitis-and-vestibular-neuritis. Accessed August 14, 2014.

    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 14, 2014.

    Labyrinthitis. Johns Hopkins Medical Center website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/specialty%5Fareas/vestibular/conditions/labyrinthitis.html. Accessed August 14, 2014.

    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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