labyrinthitis

Labyrinthitis is an inflammation of the inner ear that is often a complication of otitis media. It is caused by the spread of bacterial or viral infections from the head or respiratory tract into the inner ear.

Labyrinthitis is characterized by dizziness or feelings of motion sickness caused by disturbance of the sense of balance.

The disease agents that cause labyrinthitis may reach the inner ear by one of three routes:

Labyrinthitis can also be caused by toxic drugs.

The primary symptoms of labyrinthitis are vertigo (dizziness), accompanied by hearing loss and a sensation of ringing in the ears called tinnitus. Vertigo occurs because the inner ear controls the sense of balance as well as hearing. Some patients also experience nausea and vomiting and spontaneous eye movements in the direction of the unaffected ear. Bacterial labyrinthitis may produce a discharge from the infected ear.

The diagnosis of labyrinthitis is based on a combination of the patient's symptoms and history—especially a history of a recent upper respiratory infection. The doctor will test the patient's hearing, and order a laboratory culture to identify the organism if the patient has a discharge.

If there is no history of a recent infection, the doctor will order extra tests in order to exclude injuries to the brain or Meniere's disease.

Patients with labyrinthitis are given antibiotics, either by mouth or intravenously to clear up the infection. They may also be given meclizine (Antivert, Bonine) for vertigo and nausea.

Some patients require surgery to drain the inner and middle ear.

Patients with labyrinthitis should rest in bed for three to five days until the acute dizziness subsides. Patients who are dehydrated by repeated vomiting may need intravenous fluid replacement. In addition, patients are advised to avoid driving or similar activities for four to six weeks after the acute symptoms subside, because they may have occasional dizzy spells during that period.

Most patients with labyrinthitis recover completely, although it often takes five to six weeks for the vertigo to disappear completely and the patient's hearing to return to normal. In a few cases the hearing loss is permanent.

The most effective preventive strategy includes prompt treatment of middle ear infections, as well as monitoring of patients with mumps, measles, influenza, or colds for signs of dizziness or hearing problems.

Jackler, Robert K., and Michael J. Kaplan. "Ear, Nose, & Throat." In Current Medical Diagnosis and Treatment, 1998 edited by Stephen McPhee, et al., 37th ed. Stamford: Appleton & Lange, 1997.

Labyrinth — The bony cavity of the inner ear.

Meniere's syndrome — A disease of the inner ear marked by recurrent episodes of vertigo and roaring in the ears lasting several hours. Its cause is unknown.

Otitis media — Inflammation of the middle ear. It can lead to labyrinthitis.

Vertigo — A sensation of dizziness marked by the feeling that one's self or surroundings are spinning or whirling.

acute serous labyrinthitis a type caused by chemical or toxic irritants that invade the labyrinth, usually from the middle ear. Called also sterile or toxic labyrinthitis.

acute suppurative labyrinthitis a type in which pus enters the labyrinth, usually through a fistula after middle ear infection or through temporal bone erosion from meningitis; it results in severe and often permanent vertigo and hearing loss. Called also bacterial or purulent labyrinthitis.

bacterial labyrinthitis acute suppurative labyrinthitis.

circumscribed labyrinthitis acute serous labyrinthitis in a discrete area, due to erosion of the bony wall of a semicircular canal with exposure of the membranous labyrinth; called also perilabyrinthitis.

meningogenic labyrinthitis acute suppurative labyrinthitis that results from invasion of meningitis through an erosion of the temporal bone.

labyrinthitis ossi´ficans abnormal ossification in the labyrinth after a trauma or an infection with inflammation.

purulent labyrinthitis acute suppurative labyrinthitis.

sterile labyrinthitis (toxic labyrinthitis) acute serous labyrinthitis.