The ear is a sensitive organ of the body. Its role is to transmit and transduce sound to the brain through its various parts – the outer, middle and inner ear. It works by detecting, transmitting and transducing sound.
However, it has a significant role too. It helps in maintaining one’s sense of balance. Unfortunately, the ears are also prone to various health problems.
The inner ear has a complex system of fluid-filled tubes and sacs termed as the labyrinth. It has two main and important functions – hearing and balance. When this gets infected and inflamed, it may suffer severe damage and irreversible complications, if it’s not treated properly.
Labyrinthitis is an infection that causes inflammation of the ear, particularly in the inner ear. This condition may lead to dizziness and hearing or balance problems. Though it usually goes away after a few weeks, the symptoms tend to last longer. In severe cases, it may even lead to hearing loss.
The ear is made of three parts – the outer, middle and inner ear. The inner ear has a complex system of fluid-filled tubes which consists of the cochlea, vestibular system, and the labyrinth. The inner ear contains multiple connections of nerves that act as pathways to the brain. Inflammation in these nerves is dubbed as vestibular neuritis or vestibular neuronitis. It is sometimes hard to determine if it’s the labyrinth or the nerves that are inflamed.
When a person has labyrinthitis, the inner ear gets inflamed as a result of a viral or bacterial infection. It may affect the balance and hearing. It’s similar to another condition dubbed as vestibular neuritis, wherein the balance system gets changed, but there is no noted hearing loss.
Labyrinthitis usually affects one ear, but it can sometimes affect both ears. Many people only get labyrinthitis once, but others may have reinfection.
2Signs and Symptoms
The symptoms of labyrinthitis begin quickly and can be intense for a few days. After that, these symptoms will start to fade and can come back when the head is moved suddenly.
The signs and symptoms include:
- Nausea and vomiting
- Tinnitus or ringing in the ear
- Loss of balance
- Loss of hearing in the high-frequency range in one ear
- Having trouble focusing your eyes
- Feeling sick
- Mild headaches
- Pus or fluid leaking out of the ears
- Ear pain
- Blurred vision or double vision.
- Slurred speech
- Double vision
There is no definite cause of labyrinthitis. Sometimes, the condition comes after a viral disease like colds or the flu. Viruses or the body’s immune response may cause inflammation inside the ears.
- Trauma or injury to the head i.e. vehicular accidents
- Bacterial infections
- Alcohol abuse
- Benign tumor of the middle ear
- Medications like aspirin, furosemide, phenytoin
- Benign paroxysmal positional vertigo
- Tumors in the brain
- Viral infection in the middle ear
- Stomach viruses
- Herpes viruses
- Respiratory illness i.e. bronchitis
You have an increased risk of having labyrinthitis if you:
- Smoke cigarettes
- Abuse alcohol
- Have history of allergies
- Always tired
- Take some prescription drugs
- Under stress
- Are taking aspirin
Diagnosing labyrinthitis is based on your symptoms, physical examination, and medical history. The doctor may ask you to move your head, body and your ears will be checked for signs of infection or inflammation.
It is important to conduct hearing tests too because this condition might lead to hearing loss. Some symptoms of labyrinthitis, however, mimic those of other conditions. Other tests will be conducted to determine if it’s labyrinthitis. These conditions include:
- Meniere’s disease
- Small stroke
- Damage to the neck arteries
- Brain Hemorrhage
- Benign paroxysmal positional vertigo
- Brain tumor
The diagnostic tests to be performed may include blood tests, hearing tests, a CT scan or MRI scan, electroencephalogram (EEG) and electronystagmography (ENG).
The treatment for labyrinthitis includes rest and medications to relieve the symptoms of dizziness and nausea. The treatment, however, on vestibular neuronitis depends on the cause.
The doctor may give medications to relieve the symptoms associated with this condition. To help the patient cope with the discomforts, the doctor can prescribe medicines for nausea and vertigo. Corticosteroids are given to reduce inflammation inside the ear.
For vertigo, the doctor can prescribe antihistaminics like cinnarizine. Another drug to use is prochlorperazine for both nausea and vertigo. Over-the-counter antihistamines like Allegra, Benadryl, and Claritin can be utilized. Other drugs used to relieve the symptoms include sedatives.
Since medications are geared toward the relief of most of the symptoms, they are called symptomatic treatment.
A viral infection causes most cases of labyrinthitis. In this condition, antibiotics can’t cure the disease. Viruses are self-limiting, which means that you have to wait for the infection to go away on its own.
Another important way to relieve the discomforts is to stay still, rest, and avoid eye straining activities like bright lights, watching the television and reading. Moreover, you’re not allowed to move suddenly because of the various symptoms you are feeling like dizziness, vertigo, tinnitus and balance problems.
Avoid making sudden changes in position. Moreover, get up slowly from lying down, sit still during an actual vertigo attack, and make sure the lights are turned to low. Darkness or bright lights are not recommended during a vertigo attack.
Vestibular Rehabilitation Therapy (VRT)
Vestibular rehabilitation therapy (VRT) is a treatment option for people who have chronic labyrinthitis. A small number of individuals suffer from dizziness and vertigo for long months and in some cases, years. This is called chronic labyrinthitis. Though the symptoms aren’t severe, these have an impact on the quality of life, and they can affect daily activities.
VRT uses exercises to help retrain the brain to compensate for the abnormal signals coming from the ear’s vestibular system. The range of exercises includes stimulating sensations of dizziness so the brain can get used to it, improving fitness and strength, improving balance and coordinating hand and eye movements.
Labyrinthitis can be prevented in certain circumstances:
Allergic Rhinitis or Allergies
People who are prone to having allergies or those who have chronic allergic rhinitis are at a higher risk of having an inflamed labyrinth. At the first symptoms of an allergy, you should take antihistamines and corticosteroids immediately, as prescribed by your doctor. This will reduce the inflammation that can occur.
Middle Ear Infection
Any infection of the middle ear has a very high risk of causing labyrinthitis. The infection should be curbed through antimicrobials, depending on the type of pathogen causing the infection.
Upper Respiratory System Infection
Any infection of the upper respiratory system may cause inflammation and swelling of the tissues in the upper respiratory tract. These tissues may affect the labyrinth too.
There are other ways to prevent labyrinthitis:
- Seek immediate treatment for any ear infection or problem
- Get medical advice on respiratory disease treatment
- Avoid head injury through safety precautions while driving. Ask your doctor about the side effects of safety helmets and wearing seatbelts during travel
- Avoid alcohol
- Ask your doctor about the side effects of any drug you’re taking
- Be proactive in reducing the risk of stroke or any blood vessel disease like eating a low fat and low salt diet, avoiding smoking, getting treatment for hypertension, maintaining a healthy weight and living a healthy lifestyle.
- Exercise regularly.
Spontaneous recovery is common within a few days to weeks. It depends on the patient because, in some people, the disease does not recur while in others, relapse is common. The severe symptoms of vertigo usually pass within days to about three weeks. However, the feeling of imbalance may continue for months, especially when the patient would dart.
The prognosis of labyrinthitis is good, especially for the patient has no acute neurologic impact. However, when a patient has serious neurologic complications like for example, bacterial meningitis, stroke, and hydrocephalus, it may require long-term therapy.
When there is an injury to the inner ear, the brain can go through changes to adapt to the impaired sensory input and reduce the perception of vertigo. Dubbed as vestibular compensation, this process helps a patient return to his or her normal state.
However, in some people, the process becomes altered, leading to incomplete vestibular compensation. As a result, they continue to have vertigo.
The hearing loss that results from suppurative labyrinthitis is irreversible. The inflammation may be treated with corticosteroids, and this can help retain some hearing. Patients with serous labyrinthitis often recover their hearing. In children with meningitis, hearing loss can be permanent.
Labyrinthitis is preventable and treatable, as long as you don’t wait for the symptoms to worsen before you consult with a health professional. Any problem with hearing and the ears should be taken seriously. Taking a long time to seek medical help might lead to serious consequences and worse, hearing loss.