Causes:
*Often develops post ear infection or upper respiratory infection (URI).
*May develop after an allergy, consuming medications that are hazardous to the inner ear, or after a cholesteatoma (congeital or due to chronic ear infections).
*Cholesteatoma is malfunction in the eustachian tube, negative pressure builds up in the middle ear, pull part of the tympanic membrane into the middle ear, a fluid pocket forms in the middle ear containing dead skin cells and waste and can become infected, can cause damage to ear bones or structures if continues to grow).
Increased Risks:
*Excessive alcohol consumption
*Fatigue
*H/O allergies
*Recent URI, ear infection, or virus
*Smoking
*Stress
*Certain prescription or non-prescription medications-in particular ASA
Symptoms:
*Vertigo
*Nystagmus (uncontrollable eye movements-up/down, side-to-side, circular)
*Dizziness
*Loss of hearing-unilateral
*Unbalanced
*N/V
*Tinnitus
Tests/Exams:
*EEG (electroencephalogram)
*CT head
*MRI head
*Audiometry
*Caloric stimulation-warming and cooling of inner ear to test eye reflexes
Treatment:
*Treatment of Symptoms: antihistamines, steroids-severe cases, companzine-N/V, meclizine or scopalamine-dizziness, Valium-anxiety.
*Persistent Balance Issues: physical therapy may be recommended.
*Minimizing Symptoms: rest, gradually return to normal activities, advoid quick movements, do not read if symptoms are present, avoid bright, well-lit areas.
Prognosis:
*Severe vomiting requires hospitalization.
*May take 2-3 months to completely heal.
*Older patients may continue to have dizziness indefinitely.
*Hearing may return to normal (in most cases) but loss or damage may be permanent.
Possible Complications:
*Irreversible hearing loss (rare)
*Personal injury or injury to someone else if vertigo present
*Inflammation may spread to brain or other areas in ear (rare)
Call Physician if:
*Dizziness
*Vertigo
*Loss of balance
*Hearing loss
Emergent:
*Diplopia
*Paralysis or weakness
*Slurred speech
*Convulsions
*Persistent vomiting
*Vertigo
*Fever >101 degrees
Prevention: *Treat ear infections and URI's early, do not wait thinking it will go away.
References:
Alsalam, H. (2010, November 13). Labyrinthitis ossificans, bilateral. Retrieved from http://radiopaedia.org
U.S. Department of Health and Human Services, National Institutes of Health. (2008). Labyrnthitis Bethesda, MD: U.S. National Library of Medicine. Retrieved from http://www.nlm.nih.gov.
Wardlow, J. (2009). Viral labyrinthitis, (vestibular neuronitis). Retrieved from http://www.westsuburbanent.com
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| Structures of the Ear |
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| Labyrinthitis ossifications |
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| Bilateral Labyrinthitis Ossifications: Left >Right |
