Labyrinthitis

At a Labyrinthitis an infection occurs in the inner ear. The labyrinth of the ear ignites.

What is labyrinthitis?

Typical symptoms of labyrinthitis include vomiting and vertigo. If only the labyrinth of the ear is affected, spontaneous nystagmus occurs on the affected side of the body.
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The Labyrinthitis is one of the inner ear diseases. In medicine it also bears the name Internal otitis. The organ of equilibrium and the cochlea are affected by the infection. It either develops directly in the inner ear or is caused by an inflammation outside the ear.

Doctors differentiate between two forms of labyrinthitis. There is circumscribed and diffuse labyrinthitis. In the circumscribed form, there is an erosion of the lateral semicircular canal, which can happen in a cholesteatoma, which is a chronic, purulent inflammation of the middle ear. Diffuse labyrinthitis shows up in serous inflammations such as acute otitis media (acute otitis media).

Labyrinthitis can affect people of all ages. In most cases, the infection occurs in babies and young children. Adult people, on the other hand, suffer less from the disease.

causes

The causes of labyrinthitis are varied and depend on the respective form:

• tympanogenic labyrinthitis
• Syphilis labyrinthitis
• meningogenic labyrinthitis
• viral labyrinthitis

Tympanogenic labyrinthitis is also called serous labyrinthitis. It is caused by an otitis media that spreads to neighboring structures. During this process, toxins spread to the inner ear via the oval or round window in the middle ear. In this way, inflammation develops in the structures of the inner ear.

A syphilis labyrinthitis is when it comes to a labyrinthitis in the second or third stage of a syphilis disease. The inflammation is often accompanied by syphilitic pleurisy (pleurisy) or meningitis (meningitis). Meningogenic labyrinthitis is caused by bacteria such as meningococci or pneumococci.

These cause meningitis, which in turn leads to labyrinthitis. The pathogens can penetrate towards the inner ear via the aqueductus chochlae. Meningogenic labyrinthitis is characterized by a labyrinth failure. Viruses, like bacteria, can cause labyrinthitis. The inflammation is preceded by diseases such as measles, mumps or zoster oticus.

In rare cases, autoimmune diseases such as Wegener's disease are also responsible for labyrinthitis. There are also some risk factors that encourage labyrinthitis to develop in adults. These include heavy consumption of alcohol and cigarettes, the use of certain drugs such as aspirin, extreme stress or chronic fatigue. Another risk factor is a previous exposure to allergies.

Symptoms, ailments & signs

Typical symptoms of labyrinthitis include vomiting and vertigo. If only the labyrinth of the ear is affected, spontaneous nystagmus occurs on the affected side of the body. If the labyrinth fails, this leads to nystagmus on the opposite side. The patient's hearing also suffers from the disease.

Purulent labyrinthitis is a possible complication. Symptoms such as vomiting and dizziness become even more intense. Furthermore, numbness can occur. In the worst case, the labyrinthitis spreads further through the internal ear canal. Another possible complication is labyrinthostitis, which poses a risk of meningitis. Other symptoms of labyrinthitis may include tinnitus, loss of balance, and trouble focusing your eyes.

Diagnosis & course of disease

To diagnose labyrinthitis, a physical examination takes place, which is usually combined with an ear examination. When creating an audiogram, sensorineural hearing loss can often be identified. If it is a purulent labyrinthitis, it is important to recognize bony involvement.

Computed tomography (CT) or magnetic resonance imaging (MRI) is performed for this purpose. If the doctor performs an otoscopy, an effusion can usually be found. If meningitis is suspected, a CSF puncture is performed, during which the doctor takes nerve fluid.

In most patients, the symptoms of labyrinthitis go away on their own after one to three weeks. It can sometimes take a few months for complete recovery. During the recovery phase, it is possible to gradually go back to everyday activities. Labyrinthitis rarely turns into a chronic form. Usually it only shows up once in a lifetime.

Complications

Labyrinthitis primarily causes severe and, above all, unpleasant symptoms in the patient's ears. In most cases this leads to a hearing loss. This reduces the overall hearing ability, which can lead to severe psychological complaints or depression, especially in children and young people.

Labyrinthitis also significantly limits the development of children. In the worst case, the affected person suffers from complete deafness. Furthermore, the disease leads to fever and vomiting and thereby extremely reduces the quality of life. Patients may also suffer from tinnitus or other noises in the ear.

It is not uncommon for sleep problems or disorders of concentration and coordination to occur. In most cases, the symptoms of labyrinthitis are only temporary and disappear again after a few weeks or a few months. As a rule, there are no particular complications. Treatment of labyrinthitis is carried out with the help of drugs and, as a rule, leads to success. The life expectancy of the patient is not reduced or restricted by the labyrinthitis.

When should you go to the doctor?

People who suffer from labyrinthitis should consult their family doctor at an early stage. Parents who notice signs of the disease in their child are best advised to consult the pediatrician immediately. If symptoms such as hearing problems, pain or balance disorders arise, medical advice is required in any case.The doctor can rule out or diagnose the inner ear disease and then immediately initiate therapeutic measures.

People who have had inflammation of the inner ear or pleurisy are at risk. You should consult your family doctor or a competent ENT doctor quickly if you have any of the symptoms mentioned. Other contacts are the internist or ear specialist. If complications arise, the patient must be brought to the doctor's office immediately. Hearing loss must be clarified as well as persistent sleep problems or psychological side effects. The same applies to fever and vomiting if the symptoms lead to health problems. If there are signs of a circulatory collapse, the emergency doctor must be called or the person affected must be taken to a specialist clinic quickly.

Treatment & Therapy

The therapy for labyrinthitis depends on the triggering cause. For example, if bacteria are responsible for the infection, antibiotics are used. If, on the other hand, viruses cause the disease, they can be combated with antivirals such as acyclovir. Corticoids such as prednisone and rheological agents to promote blood circulation are also considered helpful.

If the patient suffers from labyrinthitis, for which an autoimmune disease is responsible, he is given immunosuppressants. In addition, drugs are prescribed that work against nausea and dizziness. This includes Antivert. If the vertigo persists over a longer period of time, physical or occupational therapy exercises are considered useful, which serve to improve the sense of balance.

If the labyrinthitis is accompanied by a meltdown of the bones, a surgical procedure such as a mastoidectomy takes place. If the necrosis is advanced, a labyrinthectomy can also be performed.

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Outlook & forecast

The prognosis for labyrinthitis is favorable in most patients. This health disorder has the prospect of spontaneous healing. If the causes of the disease are clarified and the triggering elements are rapidly reduced, an improvement in the situation can often be documented within 2-3 weeks. It is important to work closely with a doctor for this, since a diagnosis is made as quickly as possible using various medical tests and the cause is thereby revealed.

Nevertheless, even with an optimal course of the disease, it takes several months until symptoms are finally free. In addition, the triggering stimuli for disrupting the functional activity of the ear must be completely avoided in the long term. If stress triggers or emotional stressful states are responsible for the disease, a change in lifestyle and cognitive processing are particularly important for a good prognosis. Otherwise there is a risk of the symptoms recurring in the course of life.

With an autoimmune disease, the affected person needs long-term drug therapy. Without a collaboration with a doctor, no relief from the symptoms can be achieved. Rather, there is a risk of secondary diseases. Because of dizziness and imbalances, the general risk of accidents is increased. This makes it difficult to cope with everyday life and the fulfillment of professional obligations to a considerable extent.

prevention

As a preventive measure against labyrinthitis, in the case of flu-like infections and inflammation of the middle ear, it is recommended to ensure that the ear is swollen and ventilated. If a child suffers from otitis media frequently, it is essential to visit an ENT doctor to ensure that there are no congenital disorders of ventilation. Vaccinations for young children are also important.

Aftercare

In most cases, those affected by labyrinthitis have only a few measures and options for direct follow-up care. First and foremost, the infection in the ear must be treated correctly in this disease so that there are no further complications or other complaints. The earlier a doctor is contacted, the better the further course of the disease is often.

Therefore, those affected should ideally consult a doctor at the first symptoms and signs of the disease in order to prevent the symptoms from worsening. In most cases, various medications will be necessary to relieve the infection. It is always important to ensure that the dosage is correct and that the medication is taken regularly.

In the event of uncertainties or side effects, a doctor should always be contacted first. In most cases, the labyrinthitis can be relieved relatively easily, so that there are no other complications from this disease. The ear should be particularly well protected during the treatment.

You can do that yourself

The labyrinthitis definitely requires medical treatment. What measures the person affected can take to alleviate the symptoms depends on the symptoms and the medical therapy.

Rest and bed rest help against nausea, vomiting and vertigo. If hearing is severely impaired, a hearing aid can be worn for a short time. In most cases, however, this is not possible due to the inflammation and the person concerned should instead take sick leave for a few days. In addition to the medical treatment, the patient may also use homeopathic remedies. This should be done in consultation with the responsible medical professional. The doctor can then refer the patient to a suitable specialist. If symptoms of meningitis appear, this requires immediate medical clarification. It is best to refrain from self-help measures.

Regular check-ups by the doctor are advisable to avoid spreading the infection. It can sometimes take a few weeks to months for full recovery. Daily activities should only be resumed after the acute phase of illness. Exercise can support the healing process, but should be done with earmuffs or similar aids.