Labyrinthitis is an inner ear infection that can affect a person’s balance and hearing. It may occur when a cold, the flu, or a middle ear infection spreads to the inner ear.
This article will cover the causes, symptoms, diagnosis, and treatment of labyrinthitis.
Labyrinthitis can affect hearing and balance.
The inner ear, also known as the labyrinth, is responsible for both hearing and balance. The labyrinth consists of two main parts:
- The cochlea is a small, snail-shaped structure that converts sound vibrations into nerve impulses that travel to the brain.
- The vestibular system consists of a complex network of semicircular canals that play an important role in maintaining balance by providing information about the body’s spatial orientation.
Both the cochlea and vestibular system send information to the brain via the vestibulocochlear nerve.
Labyrinthitis is an infection of the inner ear. It causes inflammation that can affect the structures of this part of the ear and disrupt the flow of sensory information from the ear to the brain. This disruption can result in a range of symptoms, including dizziness, vertigo, and even hearing loss.
Viral infections are the most common cause of labyrinthitis, but the condition can sometimes result from a bacterial infection.
While both types of infection can cause similar symptoms, bacterial labyrinthitis is generally more severe than viral labyrinthitis. The treatments for the two are very different, so it is important that a person gets the correct diagnosis from a doctor.
Anyone can develop labyrinthitis, but some conditions can increase the risk. These include:
- upper respiratory infections, such as the common cold and the flu
- middle ear infections
- head injuries
- respiratory illnesses, such as bronchitis
- viral infections, including herpes and measles
- autoimmune conditions
Other factors that may increase the likelihood of labyrinthitis include:
- heavy alcohol consumption
- a history of allergies
- use of specific medications
Symptoms of labyrinthitis
Symptoms of labyrinthitis can include tinnitus, hearing problems, dizziness, and nausea.
The symptoms of labyrinthitis can appear suddenly and without warning. Some people with this infection may experience symptoms that last for a few weeks but then disappear on their own.
However, other people may experience long-term or reoccurring symptoms that appear when they move their head suddenly.
Symptoms of labyrinthitis include:
- vertigo, which gives a person the sensation of spinning or the world spinning around them
- tinnitus, which is ringing in the ears
- loss of balance
- hearing or vision problems
Types of labyrinthitis
There are several different types of labyrinthitis, which we cover in more detail below.
Most cases of labyrinthitis are due to viral infections, such as a cold or the flu, spreading to the inner ear. Viral labyrinthitis typically results in sudden vertigo, nausea, and vomiting. Sometimes, it also leads to hearing loss.
Viral labyrinthitis usually goes away on its own. Medications for this form of labyrinthitis aim to relieve symptoms, such as dizziness and nausea.
There are two main types of bacterial labyrinthitis:
Also called toxic labyrinthitis, serous labyrinthitis commonly results from a bacterial infection in the middle ear, which doctors refer to as chronic otitis media (COM). COM causes a fluid buildup in the middle ear, which can progress to the inner ear if a person does not receive treatment.
Serous labyrinthitis is the less severe type of bacterial labyrinthitis, and hearing loss only affects high-frequency sounds. The symptoms of serous labyrinthitis include:
- mild vertigo
- nausea or vomiting
This form of labyrinthitis occurs when bacteria in the middle ear enter the inner ear. The symptoms are more severe than those of serous labyrinthitis, and they typically affect just one of the ears.
Symptoms of suppurative labyrinthitis include:
- severe vertigo
- nausea and vomiting
- nystagmus, which is a condition that causes repetitive and uncontrolled eye movements
- hearing loss
A person should see a doctor as soon as any symptoms of labyrinthitis appear. Labyrinthitis can resolve without treatment, but determining the cause of the condition is key to preventing long-lasting complications.
A doctor can determine whether a viral or bacterial infection is responsible for the symptoms. They may prescribe antibiotics for bacterial labyrinthitis.
Even if the labyrinthitis clears on its own, it is a good idea to ask a doctor to assess whether or not the condition has caused any permanent damage.
There are no specific tests to diagnose labyrinthitis. A doctor will usually carry out a thorough physical examination and neurological evaluation to rule out any other conditions, such as:
Rarely, structural abnormalities inside a person’s head can cause symptoms of labyrinthitis. To rule these out, a doctor may recommend imaging tests, such as a CT or MRI scan.
Over-the-counter antihistamines may ease some of the symptoms of viral labyrinthitis.
The purpose of labyrinthitis treatment is to relieve symptoms. A person can take over-the-counter antihistamines to ease some of the symptoms of viral labyrinthitis, such as nausea or dizziness. Stronger antihistamines, such as meclizine or promethazine, are available on prescription.
A doctor may also prescribe corticosteroids or sedatives for people with more severe symptoms. In cases where a bacterial infection is responsible for labyrinthitis, they may prescribe antibiotics.
If symptoms persist for several months, the doctor may need to check the individual for signs of permanent hearing damage. Following this, they can advise on whether or not a hearing aid may be helpful.
When labyrinthitis is chronic, or long-term, a person may benefit from a type of physical therapycalled vestibular rehabilitation. This therapy involves exercises that aim to improve balance and reduce dizziness.
Therapists typically tailor vestibular rehabilitation to an individual’s specific needs, but some common exercises include:
- moving the eyes up and down and from side to side
- bending the head forward and backward
- turning the head from side to side
- bending the torso forward
- leaning the torso over to each side
- catching and throwing a ball
- walking up and down on an incline
Most people can perform vestibular rehabilitation exercises at home, but a specialized physical therapist will monitor their progress and make any necessary modifications to the exercises.
Early diagnosis and treatment of labyrinthitis can reduce the risk of permanent damage to the inner ear. Severe cases of labyrinthitis can result in permanent damage to the vestibular system and varying degrees of hearing loss.
Labyrinthitis can also lead to a condition known as benign paroxysmal positional vertigo (BPPV). BPPV is a type of vertigo that results from sudden movements of the head. This condition is not life-threatening, but it can increase a person’s risk of falls.
Labyrinthitis is not life-threatening. In most cases, hearing and balance return to normal over time. Symptoms of vertigo and dizziness usually only last for a few days.
Most people make a full recovery provided that they receive proper treatment, especially for bacterial labyrinthitis. Recovery from labyrinthitis usually takes a few weeks.
While recovering from labyrinthitis, a person should rest and avoid any sudden movements of the head. As this condition can significantly affect a person’s balance and coordination, it is also essential to avoid driving and operating potentially dangerous machinery.
During a vertigo attack, a person should try to remain calm and avoid unnecessary movement. It is best to avoid bright lights and television or computer screens during an attack. Instead, find a quiet place to sit down and wait for it to pass.
People who experience chronic labyrinthitis should speak with their doctor about other treatment options, such as vestibular rehabilitation.
By Jamie Eske