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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 affects hearing, balance, and eye movement.

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Causes  

Labyrinthitis may be caused by:

  • Viral or bacterial infection
  • Head injury
  • Disease of blood vessels
  • Stroke
  • Nerve problems
  • Autoimmune disease
  • Side effects of drugs, including:
    • Certain antibiotics
    • Aspirin
    • Quinine—may be used for malaria treatment
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Risk Factors  

Factors that increase your risk for labyrinthitis include:

  • Current or recent viral infection (especially a respiratory infection)
  • Allergies
  • Smoking
  • Drinking too much alcohol
  • Stress
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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:

  • Vertigo (spinning sensation)
  • Dizziness

Other symptoms may include:

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

The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis is based on the symptoms and the results of your exam.

Tests may include:

  • Examination of the middle ear for signs of a viral or bacterial infection
  • Neurologic examination
  • Maneuvers for evaluating for other causes of dizziness (Dix-Hallpike maneuver)
  • Hearing tests
  • Electronystagmogram—a test of eye movement
  • CT scan or MRI scan —to look at structures in the head
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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 loss of balance and dizziness
  • Steroids—in limited situations, to help control inflammation

Anti-viral medication may be given if a virus is involved. Antibiotics may be given if a bacterial infection in involved.

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, lie 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 dizziness. 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.

Surgery  

Rarely, labyrinthitis may be due to a break in the membranes between the middle 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 reduce your risk of getting labyrinthitis:

  • Seek prompt treatment for any ear problems or infection.
  • Get medical advice on treating respiratory infections.
  • Avoid head injury by wearing seat belts and safety helmets.
  • Ask your doctor about side effects of any medication you are taking.
  • Avoid alcohol.
  • Take steps to prevent blood vessel disease or stroke. These include: