• 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 affects hearing, balance, and eye movement.
    Labyrinthitis
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    Causes

    Labyrinthitis may be caused by:
    • Viral or bacterial infection
    • Head injury
    • Disease of blood vessels
    • Stroke
    • Nerve problems
    • Autoimmune disease
    • Side effects of drugs, including:
      • Certain antibiotics
      • Aspirin
      • Quinine—may be used for malaria treatment

    Risk Factors

    Factors that increase your risk for labyrinthitis include:
    • Current or recent viral infection (especially a respiratory infection)
    • Allergies
    • Smoking
    • Drinking too much alcohol
    • Stress

    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:
    • Vertigo (spinning sensation)
    • Dizziness
    Other symptoms may include:
    • Fatigue
    • Nausea and vomiting
    • Hearing loss
    • Involuntary eye movement
    • Ringing in the ear (tinnitus)

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis is based on the symptoms and the results of your exam.
    Tests may include:
    • Examination of the middle ear for signs of a viral or bacterial infection
    • Neurologic examination
    • Maneuvers for evaluating for other causes of dizziness (Dix-Hallpike maneuver)
    • Hearing tests
    • Electronystagmogram—a test of eye movement
    • CT scan or MRI scan —to look at structures in the head

    Treatment

    Treatment may include:

    Medications

    Medication to control the symptoms, including:
    • Antiemetics—to control nausea and vomiting
    • Vestibular suppressants—to limit loss of balance and dizziness
    • Steroids—in limited situations, to help control inflammation
    Anti-viral medication may be given if a virus is involved. Antibiotics may be given if a bacterial infection in involved.
    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, lie 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 dizziness. 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.

    Surgery

    Rarely, labyrinthitis may be due to a break in the membranes between the middle 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 reduce your risk of getting labyrinthitis:
    • Seek prompt treatment for any ear problems or infection.
    • Get medical advice on treating respiratory infections.
    • Avoid head injury by wearing seat belts and safety helmets.
    • Ask your doctor about side effects of any medication you are taking.
    • Avoid alcohol.
    • Take steps to prevent blood vessel disease or stroke. These include:

    RESOURCES

    National Library of Medicine http://www.nlm.nih.gov/

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

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/

    Healthy U http://www.healthyalberta.com/

    References

    Dizziness - differential diagnosis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated December 16, 2011. Accessed December 28, 2012.

    Inner ear infections. Vestibular Disorders Associations website. Available at: http://vestibular.org/labyrinthitis-and-vestibular-neuritis . Accessed December 28, 2012.

    Labyrinthitis. American Association of Family Physicians Familydoctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/labyrinthitis.html . Accessed December 28, 2012.

    Labyrinthitis. Johns Hopkins Medical Center website. Available at: http://vestibular.org/labyrinthitis-and-vestibular-neuritis . Accessed December 28, 2012.

    12/3/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.

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