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Introduction

Labyrinthitis is a condition in which the inner ear getsinflamed and the hearing and the balance get disturbed to a certain degree.This condition can affect just one or both ears. Local or systemic infectionsmay affect the inner ear to make things worse, they can get combined withcertain types of viruses and bacteria in order to trigger acute inflammationsof the labyrinth. This condition can also sometimes be triggered by vascular ischemiaand various autoimmune processes.

The labyrinth, mastoid, middle ear and subarachnoid spaceare anatomically related. The delicate membraneous network of the labyrinthcontains the peripheral sensory organs which are essential for one’s hearingand balance. The membranous network is surrounded by an outer osseous frameworkthat protects it. The sensory orgains contain semicircular canals, saccule,utricle and cochlea.

Causes

The labyrinthitis occurs when the membranous labyrinth getsinvaded and the auditory and vestibular end organs get damaged by inflammatorymediator and microorganisms that cause infections. Labyrinth is located in thetemporal bone’s petrous portion and it is connected to the middle ear. Itconnects the subarachnoid space with the central nervous system because itcontains the cochlear aqueduct and the internal auditory canal. The numerouspathways provide access for the harmful bacteria and viruses. Virus may alsospread in a Hematogenous way as well.

Treatments

The viral labyrinthitis requires a lot of resting andhydration. Sometimes severe vomiting and nausea may be triggered and if thatoccurs then patient may be in need of intravenous fluid and antiemetic medications.Diazepam and corticosteroids may come in handy as vestibular suppressants.Viral labyrinthitis can also be treated with steroids instead of variousantiviral agents since the steroids can be more efficient in certain cases.Certain antiviral drugs such as acyclovir can sometimes cause some vestibular andauditory damage, so it is preferable to use corticosteroids for the reductionof edema and inflammation in the labyrinth and the facial canal.

Bacterial labyrinthitis is usually treated by antibiotics,while the dosage is commonly based on sensitivity and culture results fromcertain tests. Cochlear microperfusion and antioxidant therapy can also be veryefficient in some cases. If the labyrinthitis is caused by otitis media, amyringotomy must be performed and the effusion must be evacuated. Choleastomaand mastoiditis are usually treated with surgical drainage and debridement byusing a mastoidectomy. Benzodiazepines and antiemetic can be used for thetreatment of nausea, vomiting and vertigo which are common symptoms oflabyrinthitis.

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