Labyrinthitis

Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management | References

Definition

Labyrinthitis is an inner ear disorder characterised by inflammation of the labyrinth, which includes the cochlea (responsible for hearing) and the vestibular system (responsible for balance).

Aetiology

Labyrinthitis can be caused by:

• Viral infections (most common, e.g., herpes viruses, influenza)
• Bacterial infections (less common, can be a complication of otitis media or meningitis)
• Autoimmune diseases
• Trauma to the head or ear
• Allergic reactions

Pathophysiology

Infection or inflammation affects the inner ear structures, disrupting the normal transmission of sensory information from the ear to the brain. This leads to symptoms related to both hearing and balance.

Risk Factors

• Recent upper respiratory infections
• Middle ear infections (otitis media)
• Systemic infections (e.g., viral illnesses)
• Autoimmune conditions
• Head injury
• Smoking
• Excessive alcohol consumption

Signs and Symptoms

Common signs and symptoms of labyrinthitis include:

• Vertigo (a spinning sensation)
• Hearing loss in one ear
• Tinnitus (ringing in the affected ear)
• Nausea and vomiting
• Loss of balance and unsteadiness
• Difficulty focusing the eyes due to involuntary eye movements (nystagmus)

Investigations

• Clinical history and physical examination, focusing on ear and neurological assessments
• Audiometry to evaluate hearing loss
• Electronystagmography (ENG) or videonystagmography (VNG) to assess balance function
• Magnetic Resonance Imaging (MRI) if a central cause of vertigo is suspected
• Blood tests to identify underlying infections or autoimmune conditions

Management

Primary Care Management

• Rest and hydration: To help the body recover from the infection or inflammation
• Vestibular suppressants: Medications such as prochlorperazine to reduce vertigo and nausea
• Referral to an ENT specialist if symptoms persist or are severe

Specialist Management

• Antibiotics: If bacterial infection is suspected or confirmed
• Antiviral medications: If a viral infection is identified as the cause
• Vestibular rehabilitation therapy: Exercises and physical therapy to improve balance and reduce vertigo
• Hearing aids: For patients with persistent hearing loss
• Management of underlying conditions (e.g., autoimmune diseases)
• Regular follow-up to monitor recovery and manage any complications

References

1. NICE. (2024). Labyrinthitis: Diagnosis and Management. Retrieved from NICE
2. NHS. (2023). Labyrinthitis. Retrieved from NHS
3. British Medical Journal (BMJ). (2022). Labyrinthitis: Diagnosis and Management. Retrieved from BMJ
4. American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). (2021). Clinical Practice Guideline: Labyrinthitis. Retrieved from AAO-HNS

Back to Top