Labyrinthitis is an inflammation of the portion of the inner ear that houses the semicircular canals—the three small, curved tubes in the inner ear that help maintain balance. Each canal is filled with a fluid called endolymph and contains tiny calcium stones known as otoliths. The walls of these canals are lined with crops of specialized cells capped with hairlike fibers. Movement of the head causes the fluid and the otoliths to move and press upon the fibers. When bent, these fibers send signals to the brain so it can calculate the head’s position.
Inflammation of the semicircular canals interferes with this process, generating conflicting signals to the brain, which causes severe dizziness and nausea. Although these symptoms may be frightening, full spontaneous recovery of balance function is common; recovery of hearing, however, is less predictable.
What Causes Labyrinthitis?
- Labyrinthitis usually develops following a viral infection such as the cold or flu. Another contributor: Bacterial infections that are found in nearby structures such as your middle ear may cause fluid to collect in the labyrinth (serous labyrinthitis) or fluid to directly invade the labyrinth, causing pus-producing (suppurative) labyrinthitis.
- Excessive drinking of alcohol
- Injury or trauma to your head or ear
- Certain medications, such as aminoglycosides
- Head injury
- Labyrinthitis may occur as a complication of cholesteatoma
Symptoms of Labyrinthitis
- Acute onset of vertigo (severe dizziness or a spinning sensation and loss of balance)
- Nausea and vomiting
- Ringing in the ears (tinnitus)
- Hearing loss (when labyrinthitis involves the hearing portion of the inner ear)
- Vertigo (Feeling that you are spinning)
- Nystagmus (Eye jerking)
- Otorrhea (Discharge from the external ear)
- Otalgia (An ache located in the middle or inner ear)
- Asymmetry or facial weakness
- Neck pain/stiffness
- Visual changes.
Obtain prompt treatment for ear infections, bacterial infections elsewhere in the body and allergies (especially allergies of the upper respiratory tract).
- Patient history and physical examination are needed.
- A culture of any ear discharge will be taken.
- Neurological examination of the cranial nerves, especially.
How to Treat Labyrinthitis
- No specific cure exists for labyrinthitis. Treatment is aimed at easing symptoms as recovery occurs spontaneously, usually after a period of several weeks.
- Labyrinthitis associated with a bacterial infection of the middle ear may require large doses of antibiotics.
- Fluid replacement is needed to prevent dehydration if severe vomiting has occurred.
- Medications such as meclizine (an antihistamine with an antinausea effect), prochlorperazine (an antinausea drug), scopolamine (a motion-sickness drug) and diazepam (a tranquilizer) may be prescribed.
- Rarely, surgery may be required to drain pus from the middle ear or to remove a cholesteatoma.
- A balance rehabilitation program involving self-administered physical therapy may help patients compensate for the loss of the ear’s balance inputs.
- During recovery, try to avoid positions that trigger or exacerbate dizziness. Rest in bed in a dark, quiet room with your head immobilized between pillows.
- Until vertigo subsides, do not drive or perform other activities in which loss of balance may be dangerous.
When to Call a DoctorSee your doctor if you experience persistent dizziness or other symptoms of labyrinthitis.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media