Labyrinthitis

Labyrinthitis is inflammation of the part of the inner ear called the labyrinth. The labyrinth is made up of fluid-filled channels which control balance and hearing. When the head moves, the fluid in the channels move and this tells the brain which direction a person is moving in and how far and fast they are going. This information helps the body to balance. Hearing is controlled by the part of the labyrinth known as the cochlea. When the organs of balance in an ear are inflamed the information sent to the brain will be different from the unaffected ear. This varied information can make a person feel dizzy. Hearing may also be affected if this part of the inner ear is also inflamed.

Who is affected by labyrinthitis?

Labyrinthitis can affect both men and women equally, at any age, although it is rare in children.

How is labyrinthitis diagnosed?

To reach a diagnosis a number of tests may be involved or the doctor may turn a patient’s head to see if this produces any dizziness. In some cases an MRI scan may be required. Usually only one ear is affected.

Viral labyrinthitis

In most cases, labyrinthitis is caused by a viral infection. Labyrinthitis often follows common illnesses such as a cold or flu. Viral labyrinthitis usually causes a sudden, violent onset of vertigo, nausea/vomiting as well as sudden hearing loss. As antibiotics are not effective against viruses, treatment is symptomatic and may include antivertiginous medications, antihistamines and bed rest. Within one week sufferers are usually able to sit up and after two weeks will begin to compensate for the dizziness/vertigo. Acute episodes usually end after one to two months. Although permanent vestibular damage may remain in some cases, most people recover fully from viral labyrinthitis. Vestibular rehabilitation exercises are sometimes recommended for patients after recovery, as these may help with any residual imbalance.

Bacterial labyrinthitis

With a chronic middle ear infection, bacteria may enter the inner ear through the oval or round windows, through the bone or as a result of injury to the head or ear. There may be sudden unilateral hearing loss along with nystagmus, vertigo and sickness. Treatment with antibiotics is usually successful in managing bacterial labyrinthitis and most recover fully. Care should be taken with driving, ladders or operating machinery for at least one week after the symptoms have gone as they may return.

Are there any long term effects?

For the majority, balance and hearing return to normal afterwards. Some people find they have mild dizziness when they move their head; this can happen for up to several years after they have had the infection. It is relatively uncommon for there to be complications from labyrinthitis, but they can include permanent hearing loss, tinnitus, or imbalance. This is more likely with bacterial than viral labyrinthitis.

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