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Definition
Labyrinthitis is an infection of the labyrinth, the fluid-filled chamber of the inner ear that controls balance and hearing.
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Description
The labyrinth is the inner ear consisting of the vestibule, cochlear and semicircular canals. The cochlea is concerned with hearing and the vestibule and semicircular canals with equilibrium (sense of balance). The bony portion of the labyrinth (osseous labyrinth) is composed of a series of canals tunneled out of the temporal bone.
Inside the osseous labyrinth is the membrane labyrinth, which conforms to the general shape of the osseous labyrinth but is much smaller. A fluid called perilymph fills the space (perilymphatic space) between the osseous and membranous labyrinths.
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Causes and Risk Factors
Labyrinthitis is almost always caused by viral infection, but can rarely be caused by bacteria. Viral labyrinthitis may occur during a flu-like illness or during illnesses such as measles or mumps. Bacterial labyrinthitis can be result from inadequately treated or sub-acute otitis media (infection of the middle ear), particularly if a cholesteatoma (an infected collection of debris in the middle ear) has developed and erodes a pathway into the inner ear. Infection may also reach the inner ear via the bloodstream from elsewhere in the body. Less commonly, bacterial labyrinthitis results from a head injury.
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Symptoms
The major symptoms are:
- Extreme vertigo (loss of balance and a sensation that either you or the room is spinning)
- Nausea and vomiting
- Involuntary movements of the eyes
Patients usually suffer from the acute onset of continuous, usually severe vertigo lasting several days to weeks, accompanied by hearing loss and tinnitus (ringing in the ear). During a recovery period that lasts for several weeks, rapid head movements may bring on transient vertigo. Hearing may return to normal or remain impaired permanently.
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Diagnosis
Your physician will examine your ear and ask questions whether you recently had a middle ear infection or upper respiratory infection.
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Treatment
The physician will prescribe antibiotics if you have bacterial labyrinthitis. For both bacterial and viral labyrinthitis, an anti-nausea drug and a sedative also may be recommended to combat the effects of the vertigo. You will need to rest in bed for several days.
The severe symptoms of vertigo usually pass within a few days to a week. Feelings of imbalance may persist for several weeks or even months, particularly with quick movements. Recurrence of episodes of labyrinthitis is rare.
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Questions to Ask Your Doctor
What type of infection is it?
How serious is this?
What medications will you be prescribing? Are there any side-effects?
How long will this treatment be administered?
What is the prognosis?
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