Labyrinthitis

Otitis Interna, Vestibulitis, Inner Ear Infection

What is Labyrinthitis?

Labyrinthitis is an infection of the labyrinth, the fluid-filled chamber of the inner ear that controls balance and hearing. The infection often results from the spread of bacteria from acute otitis media, viral illness or meningitis.

How is it diagnosed?

Labyrinthitis signs and symptoms

  • Vertigo (sensation that you or your surroundings are spinning around).
  • Extreme dizziness especially with head movement that begins gradually and peaks in 48 hours.
  • Involuntary eye movement.
  • Nausea and vomiting (sometimes).
  • Loss of balance, especially falling toward the affected side.
  • Temporary hearing loss (sometimes).
  • Ringing in the ear (tinnitus).

History: The individual may report symptoms of hearing loss in one ear, nausea, and a sensation of spinning (vertigo). A history of recent otitis media and upper respiratory infection is often described.

Physical exam may be normal or may show signs of upper respiratory infection. The neurological exam will show abnormal eye movements (nystagmus) and loss of hearing in one ear.

Tests: Audiometric testing and other studies may be needed to determine any underlying disorder. If drainage from the ear is present, a sample may be sent to the lab to determine if there is an infection.

How is Labyrinthitis treated?

Antibiotics are used if labyrinthitis is due to a bacterial infection. Antinausea drugs and sedatives are used to control symptoms. The individual may need to rest in bed for several days.

Medications

Ativan (Lorazepam), Valium (Diazepam), Phenergan (Promethazine), Medrol (Methylprednisolone)

Activity

Keep the head as still as possible. Rest in bed until dizziness subsides. Then resume your normal activities gradually. Avoid hazardous activities, such as driving, climbing or working around dangerous machinery, until 1 week after symptoms disappear.

Diet

No special diet, but decreasing salt and fluid intake may help.

What might complicate it?

Labyrinthitis may spread and be a precursor to meningitis. Permanent hearing loss is possible on the affected side.

Predicted outcome

The severe symptoms of vertigo usually pass within a few days to a week. Feelings of imbalance may persist for several weeks or even months, particularly with quick movements. Return to normal function depends on the speed and efficacy of treatment. In some cases, inflammation may cause severe damage within the labyrinth and result in permanent hearing loss.

Alternatives

Vertigo and Meniere's disease present similarly.

Appropriate specialists

Otolaryngologist, infectious disease specialist, internist, and audiologist.

Notify your physician if

  • You or a family member has symptoms of labyrinthitis.
  • The following occur during treatment:
    • Decreased hearing in either ear.
    • Persistent vomiting.
    • Convulsions.
    • Fainting.
    • Fever of 101°F (38.3° C) or higher.

Last updated 8 August 2011


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