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:     
  • Eat a low fat, low cholesterol diet .
  • Don’t smoke .
  • If you have high blood pressure , get it treated.
  • If you have diabetes , work closely with your doctor to keep it under good control.
  • With your doctor's approval, exercise regularly .