• Labyrinthitis

    Definition

    Labyrinthitis is swelling and irritation in the inner ear. It occurs in the labyrinth of the ear, usually effecting the nerve. The labyrinth is a series of fluid-filled tubes and sacs located in the inner ear. It may affect hearing, balance, and eye movement via the 8th cranial nerve.
    Labyrinthitis
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    Causes

    Labyrinthitis is caused by damage or impairment of the labyrinth part of the cochlea. The cochlea is a fluid-filled tube containing nerve endings that transmit sound signals to the brain. Damage or impairment occur with:
    • Infection
    • Trauma
    • Inflammation
    • Drugs

    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

    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

    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 may include:

    Medications

    Medications to control the symptoms may include:
    • 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
    • Antiviral 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

    To help reduce your chances 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.
    • Do not drink alcohol or only drink 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) https://www.nidcd.nih.gov

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

    CANADIAN RESOURCES

    Alberta Health http://www.health.alberta.ca

    Health Canada http://www.canada.ca

    References

    Infections of the inner ear. Vestibular Disorders Association website. Available at: http://vestibular.org/labyrinthitis-and-vestibular-neuritis. Accessed September 25, 2017.

    Labyrinthitis. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/labyrinthitis. Updated April 2014. Accessed September 25, 2017.

    Labyrinthitis. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/centers%5Fclinics/vestibular/conditions/labyrinthitis.html. Accessed September 25, 2017.

    12/3/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113695/Benign-paroxysmal-positional-vertigo-BPPV: Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Marcie L. Sidman, MD
    • Review Date: 09/2017
    • Update Date: 09/25/2017
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