Labyrinthitis

GENERAL INFORMATION:

What is labyrinthitis? Labyrinthitis (lab-i-rin-THEYE-tis) is an inflammation (swelling) of the labyrinth and other structures in the inner ear. The labyrinth is made up of small organs that help you hear and maintain your balance. The labyrinth is part of the inner ear and contains the nerve of the ear. The inner ear is filled with fluid that senses any change in the position of your head. When you move your head, the fluid also moves and stimulates the nerves in the inner ear. The nerves then send messages to the brain about your body position and motion.

What causes labyrinthitis? The cause of labyrinthitis is not exactly known. Labyrinthitis usually occurs after a bacterial or viral infection, such as mumps. An infection of the ear, upper respiratory tract, or the head may spread and cause an infection in the inner ear. The following are possible factors or conditions that may increase the risk of having labyrinthitis:

• Diseases: Problems with your vestibular system, such as motion sickness. The vestibular system is made up of the inner ear, nerves, and brain. Tumors in the inner ear or problems with blood supply may also cause labyrinthitis.
  
  
• Injury: An injury to the head may increase your risk of having labyrinthitis.
  
  
• Medicines: Certain medicines, such as those used to kill bacteria (germs), may damage the labyrinth.

What are the signs and symptoms of labyrinthitis? The first signs and symptoms of labyrinthitis are often sudden and severe. Vertigo is usually the most common symptom. This is a feeling that everything around you is moving, swirling, or spinning. You may also feel like you are being pulled downwards toward the floor or toward your side. You may also have any of the following:

• Dizziness or light-headedness.
  
  
• Nausea (upset stomach) or vomiting (throwing up).
  
  
• Nystagmus (abnormal fast movement of the eyes).
  
  
• Skin may turn pale, feel cold, or become sweaty.
  
  
• Tinnitus (ringing or buzzing in the ears) or hearing loss.
  
  
• Trouble keeping your balance when you are standing up.

How is labyrinthitis diagnosed? Your caregiver will take a detailed health history from you. This may include information on what triggered your signs and symptoms, when they started, and how long they lasted. You may also be asked to give information about your past diseases, activities, injuries, and medicines you are taking now and in the past.

• Physical exam: Your caregiver will do a complete physical exam on you. He may do positional testing by moving your head in different directions. This test will check to see if a problem in the inner ear is causing your condition. You may be asked to do some exercises that could make you dizzy.
  
  
• Tests: Different tests may be done depending on the condition that your caregiver thinks may be causing your labyrinthitis. These tests may be based on your health history or the presence and pattern of your signs and symptoms. They may also be based on the findings he may get from your physical exam. You may have any of the following:
  
  
  • Auditory brainstem response (ABR) test: This test plays a series of clicks through headsets on your ears. A special machine is used to measure how your cochlea and nerves react to the clicks.
    
    
  • CT scan:
    
    
    • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
      
      
    • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
    
    
  • Culture: Your caregiver may need samples from any wound discharge (pus) or secretions (mucus) from your nose or ears. A throat sample may also be collected to check for germs. These samples may show what germ is causing your disease and help caregivers know the best treatment for you.
    
    
  • Electronystagmography: This test is also called an ENG. An ENG is done to test for problems you may have with balance or dizziness. Sticky pads with wires are placed on the skin around your eyes. The wires are connected to a special machine that records information during your ENG. Warm and cool air or water is put into your ears while your eye movements are recorded. Do not drink alcohol or eat a heavy meal before this test. You may feel dizzy or sick to your stomach after the test.
    
    
  • MRI: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. You will need to lay still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

How is labyrinthitis treated? Treatment will depend on the condition causing your labyrinthitis. It aims to prevent, decrease, and relieve your signs and symptoms. You may also have any of the following:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up).
    
    
  • Antivertigo medicine: Your caregiver may give you medicine to help stop your dizziness. This medicine may help you stay calm and relaxed. It may also work by blocking acetylcholine. Acetylcholine is a body chemical that helps your nerves and the parts of your body talk to each other better. Sometimes this medicine can make you sleepy.
    
    
  • Antiviral medicine: Antiviral medicine may be given to fight an infection caused by a germ called a virus.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
  
  
• Surgery: Surgery to correct certain problems in the ears may be done. This may include removing some bones or cutting a nerve in your inner ear. Excess fluids may also be sucked out or drained by making a small slit in the eardrum.
  
  
• Vestibular therapy: This is also known as vestibular and balance rehabilitation therapy (VBRT). It is a form of exercise therapy that may be used to help decrease your dizziness, improve your balance, and prevent injuries. Ask your caregiver for more information on vestibular rehabilitation.

What are the risks of not treating labyrinthitis? Medicines for treating the signs and symptoms of labyrinthitis may cause unpleasant side effects. These may include a decrease in blood pressure, fast or slow heart beat, problems with moving, or trouble breathing. If left untreated, the infection causing your labyrinthitis may spread and cause more serious problems. You may have nerve damage that may lead to permanent hearing loss. You may also have meningitis (swelling of the coverings of the brain) or a brain abscess (pus). You may also increase your chances of falling or having accidents. Labyrinthitis may also make it difficult for you to continue your usual activities and may affect your quality of life. Ask your caregiver if you are worried or have questions about your condition, medicine, or care.

Where can I find support and more information? Having labyrinthitis may be hard for you and your family. Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American Hearing Research Foundation
  8 South Michigan Avenue, Suite 814
  Chicago, IL 60603-4539
  Phone: 1-312-726-9670
  Web Address: http://www.american-hearing.org
  

• Vestibular Disorders Association
  P.O. Box 13305
  Portland, OR 97213-0305
  Phone: 1-503-2297705
  Phone: 1-800-8378428
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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