A dangerous complication of this disease is meningitis. Therefore, the symptoms of labyrinthitis are a reason to see an ENT doctor immediately for treatment.
An important section of the inner ear is the labyrinth. It is located in the thickness of the bone and is represented by interconnected fluid-filled channels. The labyrinth consists of the cochlea, which receives sound vibrations and transforms them into electrical impulses, and the vestibular channels, which are responsible for the sense of balance. Hearing and/or vestibular function is impaired in labyrinthitis.
Often the cause of the disease remains unclear. It is believed that it can be caused by pathogenic viruses, such as influenza, or the causative agents of acute respiratory infections. Symptoms of labyrinthitis can be associated with infection with mycobacteria, streptococci, and meningococci.
Other possible causes causing aseptic (non-microbial) inflammation of the inner ear:
- Contusion, head trauma, concussion;
- An allergic reaction, such as in pollinosis;
- alcohol abuse;
- Benign neoplasm of the middle ear (cholesteatoma);
- taking certain medications, such as aspirin or furosemide, in high doses.
Tumors at the base of the brain, strokes, or blood flow disorders in the inner ear due to atherosclerosis may resemble the symptoms of labyrinthitis.
Microbial toxins or other damaging factors destroy the sensitive cells lining the labyrinth canals from the inside and the septa between them. The production of lymph inside the cochlea increases, edema develops, and serous inflammation occurs.
In the chronic course of the disease, the bony walls of the inner ear are destroyed, and the infection can easily penetrate into the blood vessels and brain tissue. Sometimes such a process is limited to the bone shaft, and then labyrinthitis is called limited.
The most common symptoms of labyrinthitis are:
- Dizziness, nausea and vomiting with no relief;
- loss of balance, sudden falls;
- moderate headache, ringing or rustling in the ear, loss of hearing;
- Nystagmus – movement of the eyeballs to the side of the lesion in the serous form or to the healthy side – in the purulent version of the course.
These signs intensify when moving the head, turning and looking up. They may persist for several days or even weeks, depending on the severity of the disease. Even after treatment of labyrinthitis has begun, the symptoms may recur, so the patient should be careful about driving and working at heights for at least a week after recovery.
Cases requiring urgent consultation with a specialist and treatment of labyrinthitis:
- Vomiting that makes it difficult to take food, water, or medication;
- Fever, ear pain, progressive hearing loss;
- severe headache or dizziness that persists for several hours or more;
- double vision, slurred speech, weakness of facial or skeletal muscles;
- Recent ear or head trauma.
Depending on the structural changes, the following types of pathology are distinguished:
- Serous: in the channels of the labyrinth there is an increased production of fluid, increased pressure; these changes are reversible if the treatment of labyrinthitis is started in time;
- purulent: occurs with microbial damage, the fluid in the labyrinth becomes purulent, the disease is more severe, prone to chronicity;
- Necrotic: characterized by disintegration of the bony tissues of the inner ear with irreversible changes in hearing and vestibular function, most characteristic of scarlet fever.
Depending on the cause of the disease, the following variants of the disease are distinguished:
- bacterial – develops when the infection comes from the middle ear in otitis media (otogenic) or from the skull in meningitis (meningogenic); the symptoms of labyrinthitis increase gradually, and when the infection comes directly from the skull, acute dizziness, nausea and other signs occur;
- Haematogenous – caused by the entry of the pathogen or its toxins from the blood into the inner ear, occurs in measles, epidemic mumps (mumps);
- Viral – characterized by a favorable prognosis, caused by influenza, rubella, herpes, measles, hepatitis, Epstein-Barr virus;
- Traumatic – occurs with fractures in the base of the skull, head wounds, and unsuccessful operations on the middle ear.
The most common form of labyrinthitis is viral. This disease usually develops in adults between the ages of 30 and 60 and is rarely seen in children. In the group of patients younger than 2 years of age, meningogenic purulent labyrinthitis is more common. Otogenic purulent labyrinthitis is seen in individuals of any age if they have cholesteatoma or otitis media. If the disease in a child is not caused by meningitis, however, it has a milder serous nature and a favorable course.
The success of treatment of labyrinthitis depends on its timely diagnosis. The doctor asks the patient about the age of the symptoms, their relationship to the head movements, the medications taken, concomitant diseases. This is followed by neurological and ENT examinations, otoscopy, and assessment of hearing acuity.
If necessary, additional methods of examination are prescribed – computer or magnetic resonance imaging of the skull.
The main task of diagnosis is to rule out a transient ischemic attack or stroke.
With mild forms of the disease, treatment of labyrinthitis can be performed on an outpatient basis. With pronounced manifestations, hospitalization is necessary. Before transportation, the patient is administered drugs that reduce dizziness. He is transported in a supine position.
In addition to medication prescribed by the doctor, home remedies are recommended:
- lie in the most comfortable position that alleviates dizziness;
- Limit the intake of salt, sugar, coffee, chocolate and alcohol;
- do not smoke;
- be in a quiet room, avoid all stress and irritants.
Your doctor may recommend special exercises to speed up the recovery:
- sit on the edge of the bed closer to the middle;
- turn your head to the right at 45° and quickly lie down on your left side, keeping your head turned so that you lie down on the area behind your left ear;
- stay in this position for 30 seconds;
- then sit up and repeat the same exercise on the other side;
- repeat 6 to 10 times in 1 approach, making 3 approaches a day.
Remedies of folk medicine can be used in conjunction with conventional treatment after consultation with a doctor. Plants with anti-inflammatory action are used: garlic, eucalyptus, succession, yarrow. Of these herbs make a collection, a tablespoon of which is brewed daily in a glass of boiling water, then strain and drink during the day.
To relieve nausea and dizziness, you can use infusions of mint, melissa, ginger.
Depending on the causes of the disease, antibiotics, antihistamines, glucocorticoids may be used. Dehydration and sedation therapy is indicated. During the recovery period, vitamins, general strengthening means, physical therapy may be prescribed.
Treatment of labyrinthitis by surgery is carried out with purulent and necrotic forms of the disease. Anthromastoidotomy surgery is used – opening the cavity of the inner ear and clearing it of pus and dead tissues.
Possible Complications and Prognosis
If the labyrinthitis is serous and is not accompanied by complications, the prognosis for life and health is favorable, that is, the disease usually ends in complete recovery. This is not the case with the diffuse dwarfism or necrotic variant. Even in spite of complete treatment, the patient often fails to retain his hearing, and his vestibular functions remain impaired for life.
In any variant of the disease, its acute manifestations (dizziness, nausea, vomiting) subside a few days after the beginning of treatment. Positional dizziness may bother the patient for several weeks.
The disease may have a recurrent course. The main complication of labyrinthitis is chronic hearing loss or complete hearing loss, especially in children in whom the disease occurred as a complication of bacterial meningitis. Hearing loss occurs in 20% of children after meningitis.
To prevent this complication from developing, after an intracranial infection, examination by an audiologist or ENT doctor is recommended. If there is significant hearing loss after labyrinthitis, surgical treatment may be needed – the installation of cochlear implants. These devices are implanted in the ear to replace the lost cochlear function.
Labyrinthitis may cause Meniere’s disease, a chronic pathology of the vestibular system.
In severe cases, if the bacteria gets into the blood, the disease may be complicated by meningitis or sepsis. In these cases, even a lethal outcome of the disease is possible.
Labyrinthitis can be prevented by the following measures:
- Avoid trauma to the ear and head;
- Timely treatment of acute otitis media and other ENT diseases, as well as meningitis in children;
- Contact your doctor promptly if you have any alarming symptoms.