Labyrinthitis
Labyrinthitis is an inflammation of the labyrinth, a complex system of canals in the inner ear that plays a crucial role in hearing, balance, and eye movement. This condition is most commonly caused by viral or bacterial infections, but can also result from head injuries, tumors, vascular diseases, strokes, nerve issues, or certain medications. Individuals with recent respiratory infections, allergies, or high-stress levels are at increased risk. Symptoms of labyrinthitis can vary in severity and may include vertigo, dizziness, fatigue, hearing loss, and tinnitus. Diagnosis typically involves a medical history review, physical examination, and various tests, including hearing assessments and imaging scans. Treatment options focus on alleviating symptoms and may involve antibiotics, vestibular suppressants, or steroids, depending on the underlying cause. Prevention strategies emphasize prompt treatment for ear infections, safe practices to avoid head injuries, and maintaining a healthy lifestyle to reduce the risk of vascular diseases. While most symptoms can improve over time, complications such as permanent hearing loss can occur, particularly if bacterial infections are not treated effectively.
Labyrinthitis
- ANATOMY OR SYSTEM AFFECTED: Auditory system, ears
Definition
Labyrinthitis is an inflammation of the labyrinth in the inner ear. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.
Causes
The most common causes of labyrinthitis include viral or bacterial infection. Other causes are head injury, tumors in the brain or head, disease of blood vessels, stroke, nerve problems, and side effects of drugs, including aminoglycoside antibiotics, aspirin, and quinine.
Risk Factors
Risk factors for labyrinthitis include current or recent viral infection (especially a respiratory infection), allergies, smoking, drinking too much alcohol, taking specific prescription or over-the-counter medications, and stress.
Symptoms
The symptoms can range from mild to severe and can last days or weeks. Symptoms are usually temporary but rarely can become permanent. The most common symptoms are vertigo (spinning sensation) and dizziness, and other symptoms include fatigue, nausea and vomiting, hearing loss, involuntary eye movement, and ringing in the ear (tinnitus).
Screening and Diagnosis
A doctor will ask about symptoms and medical history and perform a physical exam. Initial diagnosis is based on the symptoms and the results of the exam. Tests include an examination of the middle ear for signs of a viral or bacterial infection; hearing tests; an electronystagmogram (a test of eye movement); a magnetic resonance imaging (MRI) scan (a scan that uses radio waves and a powerful magnet to produce detailed computer images); and a computed tomography (CT) scan (a detailed X-ray picture that identifies abnormalities of fine tissue structure).
Treatment and Therapy
Treatment may include antibiotics (only for bacterial infection); medication to control the symptoms, including antiemetics (to control nausea and vomiting); vestibular suppressants, such as meclizine, to help control loss of balance and dizziness; steroids, in limited situations, to help control inflammation; antiviral medication (such as Acyclovir), which may be prescribed by a physician. Antihistamines and corticosteroids may also be prescribed to control symptoms. Without antibiotic treatment, bacterial labyrinthitis can lead to permanent hearing loss or permanent problems with balance.
Self-care measures include rest and lying still with eyes closed in a darkened room during acute attacks. The patient should also avoid movement, especially sudden movement, as much as possible, and should avoid reading. One can resume normal activities gradually after the symptoms have cleared.
In some cases, nausea and vomiting cannot be controlled. This can result in severe dehydration, which may require hospitalization to receive intravenous fluids. Rarely, labyrinthitis may be caused by 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 and Outcomes
To reduce the risk of getting labyrinthitis, one should seek prompt treatment for any ear problems or infections, get medical advice on treating respiratory infections, avoid head injury by wearing seat belts and safety helmets, practice good hand hygiene, and avoid alcohol. One should take steps to prevent blood vessel disease or stroke by eating a low-fat and low-cholesterol diet, not smoking, treating high blood pressure, controlling diabetes, and exercising regularly.
Bibliography
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Ferrari, Mario. PDxMD Ear, Nose, and Throat Disorders. PDxMD, 2003.
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