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Labyrinthitis: Types, Causes, Symptoms, Diagnosis And Treatment

Labyrinthitis is defined as an inner ear disorder. Caused by an infection or an inflammation, the condition causes an imbalance in your inner ears. It can also develop if when you have an upper respiratory infection, like the flu.

The two vestibular nerves in your inner ear are responsible for sending your brain information about your spatial navigation and balance control. And when one of these nerves get inflamed, you are said to have labyrinthitis. The condition can interfere with driving, working, and other activities. Labyrinthitis can develop at any age and in rare cases, it can cause permanent hearing loss [1] [2] .

Types Of Labyrinthitis

Viral labyrinthitis: It is the more common type, however, the exact type of virus which cause the condition has not been found yet. Viruses causing measles, mumps, hepatitis, and the types of herpes that cause cold sores, chickenpox, or shingles are asserted to have a link. The condition will only affect one ear and most probably cures on its own. However, it can return without any warning [3] .

Bacterial labyrinthitis: This type of labyrinthitis can develop in two ways that are, the bacteria from a middle ear infection can cause the entrance of toxins into the inner ear and cause inflammation and swelling. It can also develop as a result of an infection in the bones surrounding the inner ear [4] .

Causes Of Labyrinthitis

Some of the factors that can cause labyrinthitis are as follows [5] :

  • Herpes viruses
  • Viral infections of the inner ear
  • Respiratory illnesses, such as bronchitis
  • Stomach viruses
  • Infectious organisms, such as the organism that causes Lyme disease
  • Bacterial infections, including bacterial middle ear infections

Symptoms Of Labyrinthitis

The signs of the condition can arise quickly and will be intense for several days [6] .

  • Loss of balance
  • Dizziness
  • Nausea and vomiting
  • Vertigo
  • Loss of hearing in the high-frequency range in one ear
  • Tinnitus, a ringing or buzzing in your ear
  • Difficulty focusing your eyes

Risk Factors For Labyrinthitis

You have an increased risk of developing the condition due to the following factors [7] :

  • Smoking
  • Excessive alcohol consumption
  • Allergies
  • Fatigue
  • Extreme levels of stress
  • Use of prescription medications
  • Over-the-counter medications (especially aspirin)

When To See A Doctor

If you have the following symptoms, seek immediate medical attention [8] :

  • Convulsions
  • Slurred speech
  • Fever
  • Weakness
  • Fainting
  • Paralysis
  • Double vision

Diagnosis Of Labyrinthitis

The condition is usually diagnosed through a physical exam. In some people, an ear exam alone can detect the condition whereas in some people, a complete physical exam, including a neurological evaluation, should be performed [9] .

Tests for the following conditions will be carried out, to rule them out.

  • Migraine
  • Brain haemorrhage
  • Small stroke
  • Brain tumour
  • Damage to the neck arteries
  • Benign paroxysmal positional vertigo
  • Meniere's disease

The diagnosis tests will be comprised of the following [10] :

  • hearing tests
  • blood tests
  • a CT or MRI scan
  • electroencephalogram (EEG)
  • electronystagmography (ENG)

Treatment For Labyrinthitis

The medical care for the condition can help manage the symptoms. Some of the medications prescribed for labyrinthitis are as follows [10] :

  • Corticosteroids
  • Medications that can reduce dizziness and nausea
  • Over-the-counter antihistamines
  • Prescription antihistamines
  • Sedatives

If you have an active infection, you will be required to take antibiotics. Some of the other ways one could manage the symptoms are by following the below-mentioned steps [11] :

  • Get up slowly from a lying down or seated position.
  • Avoid quick changes in position or sudden movements.
  • If you are having a vertigo attack, sit still.
  • Avoid television, computer screens, and bright or flashing lights.

Ways To Manage The Symptoms Of Labyrinthitis

  • Drink lots of fluids and eat well.
  • Avoid caffeine, alcohol, salt, and tobacco [12] .
  • If you think your medications are making you feel dizzy, talk to your doctor.
  • If you start to feel dizzy, lie down right away, with your eyes closed.
  • Remove tripping hazards like area rugs and electrical chord.
  • Put non-slip mats in your bath and shower.
  • Avoid moving too quickly.
  • Don't drive if you have dizzy spells

FAQs On Labyrinthitis

Q. What triggers labyrinthitis?

A. Viral infections and bacteria.

Q. How long does labyrinthitis last for?

A. Within one week sufferers are usually able to sit up and after two weeks. Acute episodes usually end after one to two months. However, in some cases, permanent vestibular damage has been reported [13] .

Q. Can labyrinthitis be brought on by stress?

A. Although not exactly sure, labyrinthitis is said to arise from bacterial infection, head injury and extreme stress.

Q. How can I treat labyrinthitis at home?

A. Home remedies cannot treat or cure labyrinthitis, but they may help relieve symptoms. Here are some ways through which you can manage it [14] [15] .

  • Use a warm compress over the ear may ease the pain.
  • Stand or keep your head upright. Sitting can help drain the ear.
  • A salt-water gargle may help clear Eustachian tubes, and soothe a sore throat that may accompany labyrinthitis.
  • Do not smoke and limit alcohol intake.
  • Use stress management techniques to control emotional and psychological stress as stress can worsen symptoms.
  • Avoid cold and cough medicines in young children, as these can have dangerous side effects.

Q. Can I go to work with labyrinthitis?

A. Doctors assert that is advisable to not go to work with the condition.

View Article References
  1. [1] Dewyer, N. A., Kiringoda, R., & McKenna, M. J. (2018). Inner Ear Infections (Labyrinthitis). In Infections of the Ears, Nose, Throat, and Sinuses (pp. 79-88). Springer, Cham.
  2. [2] Nassiri, A. M., Yawn, R. J., Dedmon, M. M., O’connell, B. P., Holder, J. T., Haynes, D. S., & Rivas, A. (2018). Facial nerve stimulation patterns associated with cochlear implantation in labyrinthitis ossificans. Otology & Neurotology, 39(10), e992-e995.
  3. [3] de Albuquerque Maranhão, A. S., Godofredo, V. R., & de Oliveira Penido, N. (2016). Suppurative labyrinthitis associated with otitis media: 26 years’ experience. Brazilian journal of otorhinolaryngology, 82(1), 82-87.
  4. [4] Kim, C. H., Yang, Y. S., Im, D., & Shin, J. E. (2016). Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis. Acta oto-laryngologica, 136(6), 559-563.
  5. [5] Itayem, D. A., Sladen, D., Driscoll, C. L., Neff, B. A., Beatty, C. W., & Carlson, M. L. (2017). Cochlear implant associated labyrinthitis: a previously unrecognized phenomenon with a distinct clinical and electrophysiological impedance pattern. Otology & Neurotology, 38(10), e445-e450.
  6. [6] Buch, K., Baylosis, B., Fujita, A., Qureshi, M. M., Takumi, K., Weber, P. C., & Sakai, O. (2019). Etiology-Specific Mineralization Patterns in Patients with Labyrinthitis Ossificans. American Journal of Neuroradiology, 40(3), 551-557.
  7. [7] Balamayooran, G., Atkins, H. M., Whitlow, C. T., Aycock, S. T., Nader, M. A., Cline, J. M., & Caudell, D. L. (2018). Labyrinthitis Ossificans in a Cynomolgus Macaque (Macaca fascicularis). Comparative medicine, 68(3), 239-242.
  8. [8] Kaya, S., Tsuprun, V., Hızlı, Ö., Paparella, M. M., & Cureoglu, S. (2016). Quantitative assessment of cochlear histopathologic findings in patients with suppurative labyrinthitis. JAMA Otolaryngology–Head & Neck Surgery, 142(4), 364-369.
  9. [9] McNulty, B. N., & Bush, M. L. (2019). Non-fluctuating Unilateral Vestibular Loss. In Diagnosis and Treatment of Vestibular Disorders (pp. 277-290). Springer, Cham.
  10. [10] Reinshagen, K. L., & Curtin, H. D. (2019). Radiological assessment of the vestibular system. Operative Techniques in Otolaryngology-Head and Neck Surgery, 30(3), 171-179.
  11. [11] Li, V., McArdle, H., & Trip, S. A. (2019). Vestibular migraine. bmj, 366, l4213.
  12. [12] Choi, J. W., Han, K., Nahm, H., Shin, J. E., & Kim, C. H. (2019). Direction-Changing Positional Nystagmus in Acute Otitis Media Complicated by Serous Labyrinthitis: New Insights into Positional Nystagmus. Otology & Neurotology, 40(4), e393-e398.
  13. [13] Sousa, R. F., Levy, J., Campos, J., & Luis, L. (2019). Bilateral Inferior Vestibular Nerve Lesion a Late Neurotoxic Effect of Liposoluble Myelographic Contrast Agent. Clinical neuroradiology, 29(1), 163-165.
  14. [14] Esaki, S., Goshima, F., Kimura, H., Ikeda, S., Katsumi, S., Kabaya, K., ... & Murakami, S. (2011). Auditory and vestibular defects induced by experimental labyrinthitis following herpes simplex virus in mice. Acta oto-laryngologica, 131(7), 684-691.
  15. [15] Le, T. N., Westerberg, B. D., & Lea, J. (2019). Vestibular Neuritis: Recent Advances in Etiology, Diagnostic Evaluation, and Treatment. In Vestibular Disorders (Vol. 82, pp. 87-92). Karger Publishers.

Read more about: ear problem infections
Story first published: Friday, November 15, 2019, 18:30 [IST]
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