Alternative Names inner ear infection, otitis interna
Definition Labyrinthitis is inflammation of the inner ear, usually due to an infection.
What is going on in the body? The inner ear has two main functions. The first is to turn sounds into electrical signals that are sent to the brain. The second function is to aid in balance. When the inner ear gets inflamed, usually from an infection, hearing and balance may be impaired. Vertigo is a condition in which people feel that either they or the objects around them are spinning. Both symptoms may be irreversible in some cases.
What are the signs and symptoms of the infection? Symptoms of labyrinthitis often occur quickly, and may include:
A person also may have the symptoms of the infection that led to the labyrinthitis. For instance, an infection of the middle ear, called acute otitis media, or an infection of the lining around the brain, called meningitis, can lead to labyrinthitis.
What are the causes and risks of the infection? Labyrinthitis is usually caused by an infection, such as acute otitis media or meningitis. A person may also develop labyrinthitis suddenly without another infection. In these cases, the cause is thought to be a viral infection of the inner ear.
What can be done to prevent the infection? Prompt treatment of acute otitis media and meningitis with antibiotics can prevent some cases of labyrinthitis. There is no known way to prevent cases due to viral infection.
How is the infection diagnosed? Diagnosis begins with the history and physical examination, which often make a doctor suspect this condition. A hearing test can detect hearing impairments. Special testing, such as tests called electronystagmogram and caloric testing, may be done to measure these eye movements.
What are the long-term effects of the infection? With labyrinthitis caused by a bacterial infection, hearing impairment or deafness is often permanent. The balance part of the inner is also usually permanently destroyed. However, the brain can often learn to adjust to the balance problem. Because of this, the vertigo usually improves over time. It may soon only occur with fast or complex head movements.
A person with the viral form of labyrinthitis can have varying degrees of balance and hearing problems. Some people recover completely, while others have permanent problems.
What are the risks to others? Labyrinthitis is not contagious. However, acute otitis media and meningitis are often contagious.
What are the treatments for the infection? Antibiotics are given for labyrinthitis caused by bacteria, often through an intravenous line, or IV. An IV is a thin tube that is inserted though the skin and into a vein, usually in the hand or forearm. Surgery may also be needed inside the ear. Viral infection may be treated with corticosteroids, such as prednisone, and antiviral medications. If there is permanent hearing impairment, a hearing aid may be useful.
vertigo can be treated with medications such as stemetil. Medications are only used short-term for balance trouble, to allow the brain to learn to adjust to the inner ear injury. Special exercises can often help speed and improve the brain's ability to adjust.
What are the side effects of the treatments? All medications have possible side effects. For instance, antibiotics can cause allergic reactions and stomach upset. Antivertigo medications may cause drowsiness and a dry mouth. Surgery may cause further hearing loss or balance problems.
What happens after treatment for the infection? Most people need no further treatment after the infection causing labyrinthitis is cleared up. Those with balance problems are often advised to continue balance exercises to increase the brain's ability to adjust to the inner ear damage. If the hearing impairment doesn't improve within 2 weeks, the loss is likely to be permanent.
How is the infection monitored? Those with labyrinthitis caused by a bacteria are often monitored in the hospital for a short time as they receive antibiotics through an intravenous line. Others can often monitor their symptoms at home. Regular hearing tests may be advised in some cases to follow symptoms. Any new or worsening symptoms should be reported to the doctor.
Author: Mark Loury, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
