Labyrinthitis is a disorder characterized by swelling or inflammation of the inner ear or labyrinth, resulting in significant balance and hearing disturbances. This includes vertigo, disequilibrium, and nausea. It is usually caused by recent infection, typically viral, but bacterial in rare cases. Other triggers may include allergies, alcohol abuse, stress, smoking, and certain drugs.

Viral etiology is most common in adults aged 30-60 and is usually preceded by an upper respiratory tract infection; it is rare in children. Meningogenic suppurative labyrinthitis typically occurs in children younger than 2 years. Otogenic suppurative labyrinthitis may occur in individuals of any age that have cholesteatoma or untreated acute otitis media. Serous labyrinthitis is more common in children, since they are more likely to have otitis media.

Clinical signs and symptoms typically include vertigo, dizziness, hearing loss (unilateral), visual changes, loss of balance, nausea, vomiting, fever, and tinnitus. In all types of labyrinthitis, vertigo, nausea, and vomiting are acute symptoms that resolve after a few days to weeks. Hearing loss is variable in length of time to resolve. Patients with suppurative labyrinthitis may experience severe and permanent hearing loss due to labyrinthitis ossificans (ossification of the inner ear as a sequelae of infection). Bacterial labyrinthitis is responsible for about one-third of acquired hearing loss cases.

Treatment can help manage vertigo and other symptoms. Medication options include antihistamines, antiemetics, sedatives, steroids, and antiviral agents. In cases of labyrinthitis due to otitis media, surgical care may be suggested in order to treat the effusion (myringotomy).

Related topic: Vestibular neuritis