Labyrinthitis

Labyrinthitis is an inflammation of the inner ear structures (labyrinth), which includes both the hearing organ (cochlea) and the balance organ (vestibular apparatus).

A key feature of the disease is the simultaneous and, as a rule, sudden impairment of both functions of the inner ear. This leads to the appearance of unilateral symptom combination: acute dizziness and hearing impairment.

Aetiology and Pathophysiology

Most often, labyrinthitis is viral in nature and develops during or after an acute respiratory viral infection. Bacterial labyrinthitis is less common and occurs as a serious complication of purulent otitis media, when the infection spreads from the tympanic cavity to the inner ear.

Inflammation in the labyrinth disrupts the functioning of its sensory receptors. Damage to the vestibular system causes systemic dizziness (vertigo), while damage to the cochlea causes hearing loss and tinnitus.

Clinical Significance

The clinical presentation of labyrinthitis is very prominent. It is characterised by a sudden onset of severe rotational dizziness accompanied by nausea, vomiting, imbalance, as well as unilateral hearing loss and tinnitus.

The diagnosis is based on the clinical presentation and findings of an otoneurological examination. The most important task is to rule out the underlying central causes of dizziness, primarily a vertebrobasilar stroke. Treatment of viral labyrinthitis is mainly symptomatic (vestibular suppressants, antiemetics). Bacterial labyrinthitis requires emergency hospitalisation, antibiotic therapy and often surgical intervention.

Differential Diagnosis

Labyrinthitis must be differentiated from vestibular neuronitis. Acute systemic vertigo is also observed in vestibular neuronitis, but unlike labyrinthitis, hearing is not affected.