Labyrinthitis

Last reviewed: 8 Nov 2022
Last updated: 24 Sep 2021

Summary

Definition

History and exam

Key diagnostic factors

  • vertigo
  • dizziness
  • nausea and vomiting
  • hearing loss
  • otorrhea
More key diagnostic factors

Other diagnostic factors

  • nystagmus
  • tinnitus
  • vertigo-related quick head or body movements
  • influenza-like symptoms
  • otalgia
Other diagnostic factors

Risk factors

  • viral infections
  • chronic suppurative otitis media
  • acute otitis media
  • cholesteatoma
  • meningitis
  • inner ear malformations
  • autoimmune ear diseases
  • syphilis
More risk factors

Diagnostic investigations

1st investigations to order

  • audiogram
  • Weber test
  • Rinne test
More 1st investigations to order

Investigations to consider

  • CT or MRI brain
  • electronystagmography
  • rotary chair test
  • vestibular-evoked myogenic potentials
  • syphilis serology
  • cerebrospinal fluid Gram stain and culture
  • serum HIV rapid test
  • basic metabolic profile (including BUN and creatinine)
More investigations to consider

Treatment algorithm

ACUTE

viral: non-HIV

bacterial: secondary to otitis media

bacterial: secondary to meningitis

bacterial: syphilitic

HIV-associated

autoimmune

ONGOING

with persistent vestibular symptoms post-treatment

Contributors

Authors

Brandon Isaacson, MD, FACS
Brandon Isaacson

Professor

Department of Otolaryngology-Head & Neck Surgery

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

BI is an author of a reference cited in this topic.

Peer reviewers

Marc Bennett, MD

Associate Professor

The Otology Group of Vanderbilt

Nashville

TN

Disclosures

MB declares that he has no competing interests.

Joni K. Doherty, MD, PhD

Assistant Professor

Neurotology Otolaryngology-Head & Neck Surgery

USC Keck School of Medicine

San Diego

CA

Disclosures

JKD declares that she has no competing interests.

Iain Swan, MD, FRCS

Senior Lecturer in Otolaryngology

Honorary Consultant Otolaryngologist

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

IS declares that he has no competing interests.

  • Labyrinthitis images
  • Differentials

    • Vestibular neuritis
    • Benign paroxysmal positional vertigo
    • Meniere disease
    More Differentials
  • Guidelines

    • Suspected neurological conditions: recognition and referral
    • Practice guidance: vestibular rehabilitation
    More Guidelines
  • Patient leaflets

    Middle ear infection

    Outer ear infection

    More Patient leaflets
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