Labyrinthitis

 Labyrinthitis

Labyrinthitis is inflammation and infection of inner ear. 

Labyrinths houses vestibular system.

Labyrinthitis condition disturb the balance and hearing loss.

The hallmark symptoms characterized by vertigo.

Etiology

1. Acute otitis media

2. Meningitis

3. Viral infection

4. Bacterial infection

5. Upper respiratory tract infection

Clinical Manifestations

1. Hearing loss; Sensorineural hearing loss

2. Dizziness

3. Spinning sensation (vertigo)

4. Headache

5. Tinnitus 

7. Fullness of ear

8. Otorrhea

9. Otalgia

10. Nausea and vomiting 

Pathophysiology

Infectious microorganisms or inflammatory mediators invade membranous labyrinth and damage auditory organs .

Types of Labyrinthitis

1. Diffuse serous labyrinthitis

It is acute labyrinthitis. Caused by allergy, drug intoxication.

2. Diffuse suppurative labyrinthitis

Due to continuous inflammatory process exudate becomes purulent. 

Destruction of soft tissue structure from infection can result permanent hearing loss.

Diffuse suppurative labyrinthitis also known as diffuse suppurative or purulent labyrinthitis.

Mainly caused by pyrogenic infection of inner ear.

3. Circumscribed labyrinthitis

Thinning or erosion of bony capsule of labyrinth.

Diagnostic Evaluation

1. Blood culture

2. CBC

3. Otologic examination; inspect tympanic membrane, middle ear infection, cholesteatoma, 

4. Ocular examination; Inspect ocular range of motion and pupillary response.

5. Neurologic examination; Inspect cranial nerve

6. CT scan

7. MRI scan

8. Audiography

8. Vestibular testing 

To evaluate the balance organs in the inner ear are functioning.

Management

1. Management of vertigo

Meclizine

2. Management of viral labyrinthitis

Acyclovir, Famciclovir, Valacyclovir

3. Management of bacterial Infection 

Antibiotics

4. Management of Nausea and Vomiting

Antiemetic medication

5. Management of inflammation

Corticosteroids

6. Vestibular Rehabilitation Therapy

VRT therapy is exercise-based therapy used to reduce vertigo and dizziness, reduce gaze instability, and reduce imbalance problem.

Surgical Management

1. Myringotomy

2. Mastoidectomy

Prevention

1. Avoid sudden position

2. Avoid bright light

3. Prompt treat any ear inection or problem

4. Keep still and rest when symptoms occurs

5. Treat respiratory infection