Labyrinthitis definition and facts
- Labyrinthitis is an inner ear condition that causes dizziness, spinning sensation (vertigo) and problems with balance. Inner ear infections and/or other ear problems can trigger labyrinthitis.
- Symptoms of labyrinthitis include:
- Researchers and doctors do not know the cause of labyrinthitis. The condition may be caused during -or after a viral infection or by swelling or problems with the nerve in the brain that is responsible for balance and hearing.
- Viruses usually cause inner ear infections, and less commonly, bacteria.
- Medications may be prescribed for the treatment of inner ear infections associated labyrinthitis, and its symptoms like nausea, vomiting, ear pain, swelling and inflammation in the ear, and to help cure dizziness and vertigo.
- Home remedies that may help relieve symptoms of labyrinthitis include warm compresses on the affected ear, saltwater gargle, not smoking, and over-the-counter (OTC) pain relievers.
- Labyrinthitis is not contagious; however, the viruses and bacteria that cause ear infections can be.
- Good hygiene practices are important to prevent ear infections and labyrinthitis.
- If labyrinthitis is treated promptly, most bouts will resolve within a few days up to about 2 weeks, with no permanent damage to the ear.
- Labyrinthitis also may lead to a condition called BPPV (benign paroxysmal positional vertigo), which causes brief episodes of dizziness and vertigo, or Ménière’s disease, which can cause variable hearing loss, vertigo, ringing in the ears, and a feeling of fullness or pressure in the ear.
What is labyrinthitis?
Labyrinthitis is a type of inner ear condition that causes dizziness, a spinning sensation (vertigo), and problems with balance. The dizziness also can cause acute nausea and vomiting. Inflammation of the nerves in the inner ear cause labyrinthitis. The inflammation leading to labyrinthitis can be a caused by an inner ear infection, and it has many of the same symptoms as an ear infection.
The anatomy ear is divided into three parts, 1) outer ear, 2) middle ear, and the 3) inner ear.
The outer ear consists of the parts you can see outside the body, the auricle (also known as pinna), earlobe, and the ear canal up to the eardrum. The middle ear consists of the eardrum (tympanic membrane) and the auditory bones (ossicles) - the incus, malleus, and stapes. The inner ear consists of the fluid-filled semicircular canals, cochlea, vestibular nerve, and auditory nerve.
Picture of the Outer, Middle, and Inner Ear Structures
Labyrinthitis and Vertigo
There are a number of different causes of vertigo. Vertigo can be defined based upon whether the cause is a problem with the inner ear (for example, labyrinthitis and/or viral inner ear infections), or if it is caused by a problem within the brain or spinal cord.
What are the signs and symptoms of labyrinthitis?
Signs and symptoms of labyrinthitis may include (one or more):
- Spinning sensation (vertigo)
- Problems with balance
- Difficulty walking
- Hearing loss (or decrease in sound volume) in one ear
- Earache or ear pain
- Feeling of fullness in the ear
- Ringing in the ear (tinnitus) or hearing abnormal sounds
- Discharge from the ear
The symptoms of labyrinthitis are very similar to another inner ear disorder called vestibular neuritis. The two conditions have similar symptoms, but vestibular neuritis does not include hearing loss.
What causes labyrinthitis? Is it contagious?
The exact cause of labyrinthitis is unknown. It may be caused by swelling or problems with the nerve inside the brain responsible for balance and hearing. Labyrinthitis also may occur during or after a viral infection. Viruses associated with labyrinthitis include influenza, herpes viruses, measles, mumps, rubella, hepatitis, Epstein-Barr virus, and polio.
Rarely, other ear problems like barotrauma (injury due to abnormal pressure inside the ear) or otosclerosis (abnormal growth of bone impeding the middle ear) can cause labyrinthitis.
Labyrinthitis itself is not contagious, however, viral infections that lead to labyrinthitis are.
How long does labyrinthitis last?
Labyrinthitis symptoms usually last only last a few weeks. If your symptoms don’t resolve after about 3 weeks, see your doctor. If your symptoms are severe (unable to walk, excessive vomiting, headache or weakness) seek medical care immediately.
How can I tell if I have labyrinthitis? How is it diagnosed?
The only way to know if you have labyrinthitis or another ear problem is to see a doctor. Labyrinthitis symptoms such as dizziness and loss of balance can resemble other medical problems, so a doctor will rule out conditions that may cause the symptoms such as head injury, heart disease, stroke, side effects of medications, anxiety, and neurological disorders.
Make an appointment with your doctor, ENT (ear, nose, and throat specialist) or other healthcare professional if you experience symptoms of an ear infection such as:
- Ear pain
- Fullness in the ear
- Ringing in the ear or other abnormal sounds
- Discharge from the ear
- Spinning sensation
- Problems with balance or walking
- Hearing loss
The doctor will use an otoscope to examine the inside of the ear canal and eardrum to check for redness or swelling, earwax build-up, or any abnormalities in the ear. The doctor may gently puff air against the eardrum to see if it moves, which is normal. If the eardrum does not move, there may be fluid buildup in the middle ear.
A tuning fork exam may help diagnose neurologic hearing loss. Sound waves from the vibration of the tuning fork can be heard through the air and through the bones around the ear.
Balance Disorders: Vertigo, Motion Sickness, Labyrinthitis, and More
What is the treatment for labyrinthitis?
Once other conditions have been ruled out, the treatment for labyrinthitis depends on the cause, your symptoms, and how long the problem has been present.
Your doctor or other healthcare professional may prescribe medications to treat any infection, reduce swelling and inflammation, treat nausea and vomiting, and help eliminate dizziness and vertigo.
If you are having balance problems, your doctor may be refer you to a physical therapist who can prescribe exercises to help with balance.
What medications treat and cure labyrinthitis?
Labyrinthitis symptoms and any associated infection may be treated with over-the-counter (OTC) medications or prescription medications.
Your doctor may recommend OTC diphenhydramine (Benadryl), or prescription meclizine (Antivert), promethazine hydrochloride (Phenergan), lorazepam (Ativan), or diazepam (Valium) to help control nausea and vomiting, and to relieve dizziness and vertigo.
Prescription medications, for example, steroids (prednisone
), antibiotics, and antivirals may help with inflammation and treat any infection associated with labyrinthitis.
If you become dehydrated from severe vomiting, you may receive intravenous fluids in an Emergency Department.
What natural or home remedies treat labyrinthitis symptoms?
Home remedies cannot treat or cure labyrinthitis, but they may help relieve symptoms.
- Use a warm compress over the ear may ease pain
- Stand or keep your head upright. Sitting can help drain the ear.
- A saltwater gargle may help clear Eustachian tubes, and soothe a sore throat that may accompany labyrinthitis.
- Do not smoke and limit alcohol intake.
- Use stress management techniques to control emotional and psychological stress as stress can worsen symptoms.
- Over-the-counter (OTC) medications, for example, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may relieve pain. Do not give children and teenagers aspirin as this has been linked with a serious condition called Reye's syndrome.
- If your doctor approves, OTC eardrops may be used to relieve pain. Eardrops should not be used in children with tympanostomy tubes (ear tubes) unless specifically prescribed by your child’s pediatrician.
- AVOID cold and cough medicines in young children, as these can have dangerous side effects.
Some natural remedies and alternative treatments are touted as treatment or cures for labyrinthitis, including garlic oil or tea tree oil ear drops, apple cider vinegar, basil, olive oil, and hydrogen peroxide. Scientific studies do not show any of these to be effective.
Some chiropractors also claim to be able to treat labyrinthitis with manipulation; however, there currently are no studies that show chiropractic treatment to be effective for labyrinthitis.
Talk to your doctor before using any home remedies.
Can labyrinthitis be prevented?
You cannot get labyrinthitis from another person who has the condition. However, labyrinthitis often results from ear infections. An ear infection itself is not contagious, but the viruses and bacteria that cause them are. To prevent ear infections, practice good hygiene.
- Wash your hands frequently
- Avoid sharing food and drinks, especially with someone you know to have an ear infection
- Do not smoke and avoid secondhand smoke
Children should be vaccinated, specifically with pneumococcal conjugate vaccine to protect against several types of pneumococcal bacteria, which are the most common cause of ear infections.
What is the prognosis for a person with labyrinthitis? What are the complications?
- When treated promptly, most bouts of labyrinthitis will resolve in days to about 2 weeks duration, with no permanent damage to the ear.
- Labyrinthitis can lead to increased risk of hearing loss, especially in children who developed the condition as a complication of meningitis.
- Labyrinthitis can lead to a condition called BPPV (benign paroxysmal positional vertigo), which causes brief episodes of dizziness and vertigo. The dizziness can be mild to severe.
- Labyrinthitis may also lead to Ménière disease (also called idiopathic endolymphatic hydrops) to develop years after the initial infection. Ménière's disease can cause variable hearing loss, vertigo, ringing in the ears, and a feeling of fullness or pressure in the ear.
What is hearing loss?
Medically Reviewed on 1/11/2018
Hain, TC, MD. "Vestibular Neuritis and Labyrinthitis." American Hearing Research Foundation. Reviewed: Oct 2012.
NHS Choices. Labyrinthitis. Updated: Aug 07, 2017.
Patient education: Labyrinthitis (The Basics). UpToDate.