What is labyrinthitis?
Labyrinthitis is a form of inner ear condition characterized by dizziness, vertigo (a spinning sensation), and balance issues. This condition can induce acute nausea and vomiting due to the associated dizziness. Labyrinthitis results from inflammation of the nerves within the inner ear, and its symptoms often mimic those of an ear infection.
The ear's anatomy is divided into three segments:
- Outer ear
- Middle ear
- Inner ear
The outer ear includes visible parts like the auricle (pinna), earlobe, and the ear canal up to the eardrum. The middle ear comprises the eardrum (tympanic membrane) and auditory bones (ossicles), namely, incus, malleus, and stapes. The inner ear includes fluid-filled semicircular canals, cochlea, vestibular nerve, and auditory nerve.
What causes labyrinthitis?
The precise cause of labyrinthitis remains unknown. It may result from swelling or issues with the nerve inside the brain responsible for balance and hearing. Additionally, labyrinthitis may occur during or after a viral infection. Viruses linked to labyrinthitis encompass influenza, herpes viruses, measles, mumps, rubella, hepatitis, Epstein-Barr virus, and polio.
In rare instances, other ear problems such as barotrauma (injury due to abnormal ear pressure) or otosclerosis (abnormal bone growth impeding the middle ear) can lead to labyrinthitis.
While labyrinthitis itself is not contagious, the viral infections causing it can be.
What are the symptoms of labyrinthitis?
Signs and symptoms of labyrinthitis (inner ear infection) may include one or more of the following:
- Dizziness
- Spinning sensation (vertigo)
- Nausea
- Vomiting
- Problems with balance
- Difficulty walking
- Hearing loss (or decrease in sound volume) in one ear Earache or ear pain
- Feeling of fullness in the ear
- Ringing in the ear (tinnitus) or hearing abnormal sounds
- Discharge from the ear
The symptoms of labyrinthitis closely resemble another inner ear disorder called vestibular neuritis. While these conditions share similar symptoms, vestibular neuritis does not involve hearing loss.
How long does labyrinthitis last?
Symptoms of labyrinthitis (inner ear infections) typically last only a few weeks.
Consult your doctor if symptoms persist after about 3 weeks. If symptoms are severe (e.g., difficulty walking, excessive vomiting, headache, or weakness), seek immediate medical attention.
How can I tell if I have labyrinthitis?
The only way to ascertain whether you have labyrinthitis or another ear problem is to consult a doctor. Symptoms like dizziness and loss of balance may resemble those of other medical issues, necessitating the ruling out of conditions such as head injury, heart disease, stroke, medication side effects, anxiety, and neurological disorders.
Make an appointment with your doctor, an ear, nose, and throat (ENT) specialist, or another healthcare professional if you experience symptoms of an ear infection, such as:
Ear pain Fullness in the ear Ringing in the ear or other abnormal sounds Discharge from the ear Dizziness Spinning sensation Nausea Vomiting Problems with balance or walking Hearing loss The doctor will employ an otoscope to examine the inside of the ear canal and eardrum for redness, swelling, earwax buildup, or any abnormalities. Gently puffing air against the eardrum checks for normal movement; lack of movement may indicate fluid buildup in the middle ear.
A tuning fork exam may assist in diagnosing neurologic hearing loss. The vibration of the tuning fork produces sound waves that can be heard through the air and the bones around the ear.
What is the treatment for labyrinthitis?
Once other conditions are ruled out, the treatment for labyrinthitis depends on the cause, your symptoms, and the duration of the problem.
Your doctor or healthcare professional may prescribe medications to address any infection, reduce swelling and inflammation, manage nausea and vomiting, and alleviate dizziness and vertigo.
For those experiencing balance issues, a referral to a physical therapist may be made for exercises aimed at improving balance.
What medications treat and cure labyrinthitis?
Symptoms of labyrinthitis and any associated infection may be treated with over-the-counter (OTC) or prescription medications.
Your doctor may recommend OTC diphenhydramine (Benadryl) or prescribe meclizine (Antivert), promethazine hydrochloride (Phenergan), lorazepam (Ativan), or diazepam (Valium) to control nausea, vomiting, dizziness, and vertigo. Prescription medications, such as steroids (prednisone), antibiotics, and antivirals, may assist with inflammation and treat any infection related to labyrinthitis. In cases of severe vomiting leading to dehydration, intravenous fluids may be administered in an Emergency Department.
What natural or home remedies treat labyrinthitis symptoms?
While home remedies cannot treat or cure labyrinthitis, they may help alleviate symptoms.
Using a warm compress over the ear may ease pain. Standing or keeping your head upright can assist in draining the ear. A saltwater gargle may clear Eustachian tubes and soothe a sore throat accompanying labyrinthitis. Avoid smoking and limit alcohol intake. Use stress management techniques to control emotional and psychological stress, as stress can exacerbate symptoms. Over-the-counter (OTC) medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may relieve pain. Aspirin should be avoided in children and teenagers, as it has been linked with a serious condition called Reye's syndrome. If approved by your doctor, OTC eardrops may be used to relieve pain. Eardrops should not be used in children with tympanostomy tubes (ear tubes) unless prescribed by a pediatrician. AVOID cold and cough medicines in young children, as these can have dangerous side effects. Several natural remedies and alternative treatments, including garlic oil or tea tree oil ear drops, apple cider vinegar, basil, olive oil, and hydrogen peroxide, are sometimes suggested. Scientific studies do not support the efficacy of these remedies.
Some chiropractors claim the ability to treat labyrinthitis with manipulation, but no studies currently confirm the effectiveness of chiropractic treatment for labyrinthitis.
Consult your doctor before using any home remedies.
What is the prognosis and complications for labyrinthitis?
When promptly treated, most cases of labyrinthitis resolve within days to about two weeks, with no lasting damage to the ear.
Complications of labyrinthitis include:
Increased risk of hearing loss, especially in children who develop the condition as a complication of meningitis. Potential development of BPPV (benign paroxysmal positional vertigo), characterized by brief episodes of dizziness and vertigo, ranging from mild to severe. Possible progression to Ménière disease (also known as idiopathic endolymphatic hydrops) years after the initial infection. Ménière's disease can cause variable hearing loss, vertigo, ringing in the ears, and a sense of fullness or pressure in the ear.
Can labyrinthitis be prevented?
Labyrinthitis itself is not contagious, but it often results from ear infections. While ear infections are not contagious, the viruses and bacteria causing them are. To prevent ear infections, practice good hygiene.
Wash your hands frequently. Avoid sharing food and drinks, particularly with someone known to have an ear infection. Refrain from smoking and avoid secondhand smoke. Ensure children receive vaccinations, specifically the pneumococcal conjugate vaccine, which guards against several types of pneumococcal bacteria, the primary cause of ear infections.
