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Labyrinthitis  
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Definition  

Labyrinthitis is swelling and irritation in the inner ear. It occurs in the labyrinth of the ear. This is a system of cavities and canals. They affect hearing, balance, and eye movement.

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Causes  

Labyrinthitis is caused by damage or impairment of the labyrinth part of the cochlea from:

  • Infection
  • Trauma
  • Inflammation
  • Drugs
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Risk Factors  

Factors that may increase your chances of labyrinthitis include:

  • Current or recent viral infection, especially a respiratory infection
  • Allergies
  • Smoking
  • Drinking too much alcohol
  • Stress
  • Head injury
  • Disease of blood vessels
  • Autoimmune disease
  • Side effects of drugs, including:
    • Certain antibiotics
    • Aspirin
    • Quinine—may be used for malaria treatment
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Symptoms  

The symptoms can range from mild to severe and last for days or many weeks. Symptoms are usually temporary, but rarely, can become permanent.

The most common symptoms are:

  • A spinning sensation
  • Lightheadedness
  • Balance problems

Other symptoms may include:

  • Fatigue
  • Nausea and vomiting
  • Hearing loss
  • Involuntary eye movement
  • Ringing in the ear
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Diagnosis  

The doctor will ask about your symptoms and medical history. A physical exam will be done. You may also need an ear and/or a neurological exam.

This can be done with:

  • Maneuvers for evaluating for other causes of lightheadedness
  • Hearing tests

Images help evaluate the ears or other structues. This can be done with:

Your eyes may also be tested. This can be done with an electronystagmogram.

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Treatment  

Treatment may include:

Medications  

Medication to control the symptoms, including:

  • Antiemetics—to control nausea and vomiting
  • Vestibular suppressants—to limit vertigo
  • Steroids—in limited situations, to help control inflammation
  • Antibiotics—to treat a bacterial infection

Note: Without antibiotic treatment, labyrinthitis caused by a bacterial infection can lead to permanent hearing loss or balance problems.

Self-care Measures  

Some steps to help you manage your symptoms include:

  • Rest by lying still with your eyes closed in a darkened room during acute attacks.
  • Avoid movement, especially sudden movement, as much as possible.
  • Avoid reading.
  • Resume normal activities gradually after the symptoms have cleared.

Vestibular Exercises (Vestibular Rehabilitation)  

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without the sensation of spinning. You may work with a physical therapist to learn these.

Emergency Treatment  

In some cases, nausea and vomiting cannot be controlled. This can result in severe dehydration . You may need hospitalization to receive fluids and nutrients through an IV. You may also need antiemetic medication.

Surgery  

Rarely, labyrinthitis may be caused by a break in the membranes between the outer and inner ear. Surgery to repair the break may be required. If a tumor is causing the condition, surgery may also be needed.

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Prevention  

To help reduce your chances of labyrinthitis:

  • Seek prompt treatment for any ear problems or infection.
  • Avoid head injury by wearing seat belts and safety helmets.
  • Ask your doctor about side effects of any medications you are taking.
  • Avoid drinking excess alcohol.