Labyrinthitis
What is this condition?
This rare disorder is an inflammation of the labyrinth of the inner ear. It frequently incapacitates the person by causing severe vertigo that lasts for 3 to 5 days. Symptoms gradually subside over a 3- to 6-week period
What causes it?
Labyrinthitis is usually caused by viral infection. It may be a primary infection, the result of injury, or a complication of the flu, middle ear infection, or meningitis. In chronic middle ear infection, a cystlike formation called a cholesteatoma erodes the bone of the labyrinth, allowing bacteria to enter from the middle ear.
What are its symptoms?
Because the inner ear controls both hearing and balance, this infection typically produces severe vertigo (with any movement of the head) and hearing loss. Vertigo begins gradually but peaks within 48 hours, causing loss of balance and falling in the direction of the affected ear.
Other symptoms include spontaneous nystagmus, with jerking movements of the eyes toward the unaffected ear; nausea, vomiting, and giddiness; with cholesteatoma, signs of middle ear disease; and with severe bacterial infection, pus-filled drainage. To minimize giddiness and nystagmus, the person may assume a characteristic posture - lying on the side of the unaffected ear and looking in the direction of the affected ear.
How is it diagnosed?
The doctor may diagnose labyrinthitis based on a person's signs and symptoms and history of upper respiratory infection. The doctor will typically order culture and sensitivity testing to identifY the infecting organism if pus-filled drainage is present. The person may also undergo audiometric testing.
How is it treated?
Treatment of labyrinthitis seeks to control symptoms and may include bed rest, with the head immobilized between pillows; the anti-vertigo drug Antivert; and massive doses of antibiotics to combat pus-producing labyrinthitis. The person may receive oral fluids to prevent dehydration from vomiting. For severe nausea and vomiting, intravenous fluids may be necessary.
If these measures fail, the doctor will surgically remove the cholesteatoma and drain the infected areas of the middle and inner ear.
Early and vigorous treatment of predisposing conditions, such as middle ear infection and any local or systemic infection, can prevent labyrinthitis.
What can a person with labyrinthitis do?
Be aware that recovery may take as long as 6 weeks. During this time, limit activities that vertigo may make hazardous.
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