What Is Viral Labyrinthitis?

Labyrinth, or otitis media, is a common complication of purulent middle ear mastoiditis. According to the extent of the lesion and pathological changes, it can be divided into localized labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis.

Basic Information

Visiting department

ENT

Common locations

inner ear

Common causes

Often secondary to localized labyrinthitis, or caused by bacterial or viral toxins from otitis media through the vestibular or wormholes into the inner ear

Common symptoms

Dizziness, nausea, vomiting, imbalance, hearing loss, deep ear pain

Causes of serous labyrinthitis

This disease is common in chronic suppurative otitis media and labyrinthine fistula complicated by middle ear cholesteatoma, which is often secondary to localized labyrinthitis, or enters the inner ear through the vestibular window or worm window through bacterial or viral toxins from otitis media cause. Serous labyrinthitis after tympanoplasty, fenestration of the inner ear, or patellar foot resection is usually a labyrinthine reaction.

Clinical manifestations of serous labyrinthitis

1. Dizziness, nystagmus, nausea, and vomiting. The nystagmus is horizontal and rotational. The direction of the nystagmus is toward the diseased side, and if it is toward the healthy side, the condition is aggravated. Fistula tests can be positive. After proper treatment of serous labyrinthitis, the inner ear function can basically return to normal.

2. Tinnitus and hearing loss, the more severe may be sensorineural hearing loss, but not all deaf. Cases of severe hearing loss may show signs of cochlear disease such as revitalization and rehearing.

3. May have deep ear pain.

Serous labyrinthitis

1. Hearing tests are mostly sensorineural hearing loss.

2. Examination showed spontaneous nystagmus, and the initial phase was fast toward the affected side. In the later stage, the labyrinth function of the affected side was significantly reduced, the nystagmus was pointed to the healthy side, and the vestibular function was reduced to varying degrees. Fistula tests can be positive.

Diagnosis of serous labyrinthitis

Hot and cold test

Vestibular function is mostly hyperactive and may diminish later. For this type of patients, do not use hot and cold water, and use hot and cold air to prevent aggravating inner ear infection. The vestibular function of the diseased side was hyperactive in the early stage and gradually weakened in the later stage.

Blood image

Acute leukocyte counts can increase during the acute phase.

3. Other inspections

Cochlear electrogram, ear examination, ear CT examination, hearing examination, etc.

Attention and identification of purulent labyrinthitis. When purulent labyrinth occurs, the labyrinth is completely damaged, so the direction of nystagmus is toward the healthy side, and the vestibular function and the auditory nerve function of the diseased side are all lost. Although the semicircular canals of individual cases have been completely destroyed, some ear functions have been preserved. It may be because the external lymphatic cavity between the cochlea and the vestibule has a limiting membrane, which can isolate and filter the external lymphatics.

The earliest stage of acute diffuse serous labyrinthitis caused by otitis media is not easily distinguished from localized labyrinthitis during the onset. Therefore, the diagnosis can only be made through the entire process of the disease. For example, the direction of spontaneous nystagmus changes from the affected side to the healthy side, dizziness worsens, hearing loss is obvious (incomplete loss), vestibular function test is reduced (but not lost), and the treatment can Those who have improved or stopped progressing can be diagnosed as the disease.

Serous labyrinthitis treatment

1. Patients with chronic purulent middle ear mastoiditis should open the mastoid surgery under the control of a sufficient amount of antibiotics, pay attention to explore the structure of the labyrinth, and the labyrinth does not need to be opened. Serous labyrinthitis caused by acute suppurative middle ear mastoiditis should be treated with systemic anti-infective therapy, and simple mastoid excision is performed if necessary.

2. Symptomatic treatment, such as sedation with diazepam, infusion should be appropriate when frequent vomiting, and appropriate corticosteroids, such as dexamethasone.