Labyrinthitis

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Introduction

Labyrinthitis is inflammation that affects the balance center in the inner ear.  It commonly develops after a middle ear infection, upper respiratory infection, or allergies.  The main symptoms are a false sense that the environment is moving and feeling off balance.  Temporary hearing loss may occur.  Labyrinthitis may go away on its own.  Prescription medications may be used to reduce symptoms and fight infection.
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Anatomy

The ear is divided into three areas: the outer, middle, and inner ear.  Your ear not only enables you to hear, but it plays a role in balance as well.  Structures in the inner ear work with nerves to process sounds and help maintain body positioning.

The labyrinth is the inner ear structure that plays a role in hearing and balance.  Part of the labyrinth is filled with a fluid called endolymph.  Continual fluid production and reabsorption keep the level of endolymph ideal at all times.  When you move your head, the fluid moves in the labyrinth.  The fluid movement triggers a signal to your brain that lets you know that your body has moved and changed position.  This all happens automatically.
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Causes

The exact cause of labyrinthitis is unknown.  It tends to develop following a middle ear infection, upper respiratory infection, or allergies.  It may be caused by cholesteatoma, an abnormal growth in the middle ear.  Labyrinthitis may also be caused by certain medications that are harmful to the inner ear, such as aspirin.
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Symptoms

Labyrinthitis causes irritation and swelling in the inner ear.  A main symptom of labyrinthitis is vertigo.  Vertigo is the false sense that your environment is spinning.  Vertigo can cause nausea and vomiting.  You may feel off balance and have a tendency to fall toward the side of the affected ear.  The hearing in your affected ear may decrease.  You may experience ringing in the ear, called tinnitus.  Labyrinthitis can cause nystagmus, involuntary eye movements that occur after moving your head.

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Diagnosis

Your doctor can diagnose labyrinthitis by reviewing your medical history, examining you, and conducting tests.  Your doctor will use an otoscope, a lighted magnifying instrument, to view inside of your ears.  With labyrinthitis, the ears may appear normal upon examination.

Imaging tests, such as a computed tomography (CT) scans or magnetic resonance imaging (MRI) scans may be ordered to evaluate the structures inside of your ear.  More than one type of hearing test may be conducted to identify if your hearing loss is related to an inner ear problem.  Brainstem auditory evoked response (BAER) is used to evaluate hearing and neurological functions.  The test involves listening to sounds while a device records your brain’s activity.
 
Your doctor will conduct tests to identify the cause of vertigo.  Electronystagmography (ENG) is used to identify nerve damage in the ear.  ENG testing uses receptors to measure involuntary eye movements during certain procedures, such as caloric testing.  Caloric testing assesses involuntary eye movements that are produced when hot or cold water is placed in the ear. 
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Treatment

Labyrinthitis may go away on its own.  Medicine may be prescribed to ease your symptoms.  Antibiotics may be used to treat infections.  Hearing usually returns to normal following labyrinthitis.
 
It can be helpful to get plenty of rest.  You should avoid reading or bright lights, which may cause your symptoms to increase.  Your doctor may restrict certain activities, such as driving or operating machinery, until some time after your symptoms have stopped.
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Prevention

You may prevent labyrinthitis by receiving prompt treatment for middle ear infections, upper respiratory infections, and allergies.  It can be helpful to quit smoking and drinking alcohol.
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Am I at Risk

People that smoke or drink large amounts of alcohol have an increased risk of labyrinthitis.  Stress and fatigue may also contribute to the condition.

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Complications

Vertigo and balance problems can impair driving, daily functioning, and increase the risk of injury.  In rare cases, infection may spread throughout the ear and to the brain.  Permanent hearing loss rarely occurs.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.