Labyrinthitis

Labyrinthitis (LAB-uh-rin-THIE-tis) is an inflammation of the inner ear, labyrinthitis frequently incapacitates the patient by producing severe vertigo that lasts for 3 to 5 days; symptoms gradually subside over a 3 to 6-week period. This disorder is rare, although viral labyrinthitis is often associated with upper respiratory tract infections

Causes

Signs and symptoms

The main symptom of labyrinthitis is vertigo, a spinning or whirling sensation you feel although neither you nor your surroundings are moving. Vertigo is not the same as feeling dizzy. Dizziness is feeling unsteady or lightheaded, while vertigo is a sensation of whirling or spinning. Symptoms of dizziness and vertigo may be caused by many conditions other than labyrinthitis. With labyrinthitis, the vertigo begins suddenly, without warning, and often occurs 1 to 2 weeks after you've had the flu or a cold or other viral or bacterial infection. The sudden onset of vertigo may be severe enough to cause vomiting and nausea. Vertigo gradually goes away over a few days to weeks, although sudden head movement can cause vertigo symptoms for a month or longer.

You may have hearing loss and a roaring sound in your ears ( tinnitus ). Rarely-and generally only if the labyrinthitis is caused by a bacterial infection-the hearing loss may be permanent.

Diagnosis

A typical clinical picture and history of upper respiratory tract infection suggest labyrinthitis. Typical diagnostic measures include culture and sensitivity testing to identify the infecting organism, if purulent drainage is present, and audiometric testing.

When an infectious etiology can't be found, additional testing must be done to rule out a brain lesion or Meniere's disease.

Treatment

Symptomatic treatment includes bed rest, with the head immobilized between pillows; oral meclizine to control vertigo; and massive doses of antibiotics to combat diffuse purulent labyrinthitis. Oral fluids can prevent dehydration from vomiting; for severe nausea and vomiting, I. V. fluids may be necessary.

When conservative management fails, treatment necessitates surgical excision of the cholesteatoma and drainage of the infected areas of the middle and inner ear. Prevention is possible by early and vigorous treatment of predisposing conditions, such as otitis media and any local or systemic infection.

Complications

• injury to self or others during attacks of vertigo
• permanent hearing loss in the affected ear (rare)
• spread of inflammation to other ear areas or to the brain (rare)

Prevention

• Prompt treatment of respiratory infections and ear infections may help prevent labyrinthitis.
• Reduce your salt and fluid intake. Do not add extra salt to foods. Avoid carbonated beverages that contain sodium.