Labyrinthitis is a condition in which the inner ear gets inflamed and the hearing and the balance get disturbed to a certain degree. This condition can affect just one or both ears. Local or systemic infections may affect the inner ear to make things worse, they can get combined with certain types of viruses and bacteria in order to trigger acute inflammations of the labyrinth. This condition can also sometimes be triggered by vascular ischemia and various autoimmune processes.
The labyrinth, mastoid, middle ear and subarachnoid space are anatomically related. The delicate membraneous network of the labyrinth contains the peripheral sensory organs which are essential for one’s hearing and balance. The membranous network is surrounded by an outer osseous framework that protects it. The sensory orgains contain semicircular canals, saccule, utricle and cochlea.
The labyrinthitis occurs when the membranous labyrinth gets invaded and the auditory and vestibular end organs get damaged by inflammatory mediator and microorganisms that cause infections. Labyrinth is located in the temporal bone’s petrous portion and it is connected to the middle ear. It connects the subarachnoid space with the central nervous system because it contains the cochlear aqueduct and the internal auditory canal. The numerous pathways provide access for the harmful bacteria and viruses. Virus may also spread in a Hematogenous way as well.
The viral labyrinthitis requires a lot of resting and hydration. Sometimes severe vomiting and nausea may be triggered and if that occurs 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 various antiviral agents since the steroids can be more efficient in certain cases. Certain antiviral drugs such as acyclovir can sometimes cause some vestibular and auditory damage, so it is preferable to use corticosteroids for the reduction of 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 from certain tests. Cochlear microperfusion and antioxidant therapy can also be very efficient in some cases. If the labyrinthitis is caused by otitis media, a myringotomy must be performed and the effusion must be evacuated. Choleastoma and mastoiditis are usually treated with surgical drainage and debridement by using a mastoidectomy. Benzodiazepines and antiemetic can be used for the treatment of nausea, vomiting and vertigo which are common symptoms oflabyrinthitis.