Labyrinthitis

Definition

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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Causes

Causes

Labyrinthitis is caused by damage or impairment of the labyrinth part of the cochlea from:

  • Infection
  • Trauma
  • Inflammation
  • Drugs

Risk Factors

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
  • Blood vessel disorders
  • Autoimmune disorders
  • Side effects of drugs, including:

    • Certain antibiotics
    • Aspirin
    • Quinine—may be used for malaria treatment

Symptoms

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

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

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-inflammatory drugs (NSAIDs)—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

Prevention

To help reduce your chance 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.
  • Drink alcohol in moderation—Up to two drinks per day for men and one drink per day for women.

RESOURCES:

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

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

CANADIAN RESOURCES:

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 Academy 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 Medicine website. Available at:
http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/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.

Last reviewed August 2015 by Michael Woods, MD
Last Updated: 8/4/2015

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