Labyrinthitis

Labyrinthitis is an inflammatory condition affecting the contents of the otic capsule. This includes the cochlea, three orthogonal semicircular canals, and the otolith organs (utricle, saccule).

Viral infections are the most common cause of labyrinthitis. Bacterial labyrinthitis is a complication of otitis media or meningitis.

Typical presentation includes vertigo, imbalance, and hearing loss.

Diagnosis is supported by history, physical exam, and audiometry.

Treatment is typically symptomatic and primarily involves the use of vestibular suppressants and antiemetics, with ongoing management for persistent symptoms using vestibular rehabilitation.

Labyrinthitis is an inflammatory condition of the otic capsule. It is caused by bacteria or viruses that affect the inner ear, which consists of the cochlea and vestibular system. Typically, it presents with sensorineural hearing loss (that is typically irreversible), vertigo, and disequilibrium (problems with balance) and may affect one or both ears. It may be further classified as suppurative or serous. Suppurative (bacterial) labyrinthitis follows direct microbial invasion of the inner ear and usually presents with severe to profound hearing loss (that is typically irreversible) and vertigo.[1]Lindeman RC. Acute labyrinthine disorders. Otolaryngol Clin North Am. 1979 May;12(2):375-87. http://www.ncbi.nlm.nih.gov/pubmed/460880?tool=bestpractice.com [2]Kangsanarak J, Fooanant S, Ruckphaopunt K, et al. Extracranial and intracranial complications of suppurative otitis media: report of 102 cases. J Laryngol Otol. 1993 Nov;107(11):999-1004. http://www.ncbi.nlm.nih.gov/pubmed/8288994?tool=bestpractice.com [3]Goldstein NA, Casselbrant ML, Bluestone CD, et al. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg. 1998 Nov;119(5):444-54. http://www.ncbi.nlm.nih.gov/pubmed/9807067?tool=bestpractice.com Serous (viral) labyrinthitis results from inflammation of the labyrinth only and usually presents with less severe hearing loss and vertigo than suppurative labyrinthitis, and the hearing loss often recovers.