What Are the Different Types of Treatment for Labyrinthitis?
Labyrinth, or otitis, is caused by ear infections that invade the labyrinth or membrane labyrinth of the inner ear. It is a common complication of purulent middle ear mastoiditis. According to the extent and course of the disease, it can be divided into three types: localized labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis.
Basic Information
- nickname
- Otitis
- English name
- labyrinthitis
- Visiting department
- ENT
- Common causes
- Ear infections invade the inner ear bone labyrinth or membrane labyrinth
- Common symptoms
- Dizziness, nausea, vomiting, spontaneous nystagmus, hearing loss
Causes of labyrinthitis
- Virus infection
- Serum measurements after the illness showed that herpes simplex virus and shingles virus titers were significantly increased.
- 2. Vestibular nerves are stimulated
- Vestibular nerves suffer from vascular compression or arachnoid adhesions, and even cause hypoxia degeneration due to internal auditory stenosis, which is caused by firing nerve discharge.
- 3. Lesion factors
- There may be an autoimmune response.
- 4. Diabetes
- Diabetes can cause degeneration and atrophy of vestibular neurons, leading to repeated episodes of dizziness.
- In some patients, after pathological examination of the vestibular nerve, it can be found that the vestibular nerve has arc degeneration or scattered degenerative changes and regeneration, nerve fibers are reduced, ganglion cell vacuoles are formed, and collagen deposits in the nerve are increased.
Clinical manifestations of labyrinthitis
- Localized labyrinthitis
- Paroxysmal or stimulant dizziness, occasionally with nausea, vomiting, dizziness, mostly in rapid turns, flexion, driving, in-ear operations (such as ear picking, ear washing, etc.), when the tragus or the nose is pressed, the number of attacks Minutes to hours, the symptoms of the middle ear mastoiditis worsen during the acute phase. Spontaneous nystagmus can be seen during the onset of vertigo, and the direction is biased to the affected side, which is mostly caused by the irritation of the labyrinth on the affected side. The nature and extent of hearing loss and deafness are the same as those of otitis media, and the fistula in the head of the drum is mixed deaf.
- 2. Serous labyrinthitis
- Dizziness, nausea, vomiting, and imbalance of balance are the main symptoms of the disease. The patient prefers to lie on the affected side (the nystagmus and fast phase side) and falls to the healthy side when standing. The nystagmus is horizontal-rotational, and the labyrinth of the affected side is excited and agitated, so the nystagmus is facing the affected side quickly. In the later stage, the labyrinth function of the affected side is significantly reduced, the nystagmus is pointed to the healthy side, the vestibular function is reduced to varying degrees, and the fistula test can be positive. Hearing was significantly reduced, and he was sensory deaf, but not all deaf. May have deep ear pain.
- 3. Purulent labyrinthitis
- Dizziness, conscious foreign objects or self-rotation, nausea, frequent vomiting, closed eyes of the patient, curled side lying on the side of the nystagmus fast phase, afraid to move, imbalanced. Tinnitus and deafness. Spontaneous nystagmus, fast to the healthy side, the intensity is large, torso dumped to the slow side of the nystagmus,-once the fast nystagmus phase from the healthy side to the affected side, you should be alert to the possibility of intracranial complications. Body temperature is generally not high. If there is fever and headache, accompanied by changes in cerebrospinal fluid (such as increased white blood cell counts and increased cerebrospinal fluid pressure), the infection spreads to the skull. Because the labyrinth was damaged, the fistula test was negative.
Labyrinthitis
- Hot and cold temperature change test
- Vestibular function is partially or completely lost, sometimes showing a bias towards the healthy side.
- Blood image
- Acute leukocyte counts can increase during the acute phase.
- 3. Other inspections
- Cochlear electrogram, ear examination, otoscopy, CT examination of ENT.
Diagnosis of labyrinthitis
- Localized labyrinthitis
- (1) Medical history: Long-term history of chronic suppurative otitis media, especially patients with middle ear mastoiditis with cholesteatoma formation, bone destruction and granulation formation.
- (2) Symptoms paroxysmal or evoked vertigo, accompanied by nystagmus.
- (3) Check for hearing loss, fistula test is generally positive, and vestibular function tests are mostly normal or hyperactive.
- 2. Serous labyrinthitis
- (1) History of purulent middle ear mastoiditis.
- (2) Symptoms of persistent dizziness, imbalance, and hearing loss.
- (3) Spontaneous nystagmus, horizontal-rotational signs .
- 3. Purulent labyrinthitis
- (1) History of purulent middle ear mastoiditis.
- (2) Severe dizziness and hearing loss.
- (3) Signs of spontaneous nystagmus. There was no response to the hot and cold test and fistula test.
Labyrinthitis treatment
- Localized labyrinthitis
- (1) Drug treatment is generally dominated during the onset of drug treatment, such as intravenous drip of antibiotics plus appropriate amount of dexamethasone. Appropriate application of sedatives.
- (2) Antibiotic therapy The mastoid surgery is performed under the control of a sufficient amount of antibiotics (norfloxacin, cefazolin sodium). After the lesion is removed, the fistula can be covered with the temporal fascia. When the fistula is large, a healthy bone fragment of appropriate size can be embedded in the fistula and covered with temporal fascia.
- 2. Serous labyrinthitis
- (1) Patients with systemic anti-infective treatment complicated by chronic suppurative middle ear mastoiditis should undergo mastoid surgery under the control of a sufficient amount of antibiotics, and the labyrinth does not need to be opened. Serous labyrinthitis caused by acute purulent middle ear mastoiditis should be treated with systemic anti-infective therapy, and simple mastoidectomy is performed if necessary.
- (2) Symptomatic treatments such as stabilization and sedation. Appropriate infusion should be used when vomiting is frequent, and appropriate steroid hormone drugs, such as dexamethasone.
- 3. Purulent labyrinthitis
- (1) Antibiotics Mastoid surgery was performed immediately under the control of a large number of antibiotics.
- (2) When intracranial complications are suspected during the operation, perform mastoid surgery and cut the labyrinth to facilitate drainage.
- (3) pay attention to water and electrolyte balance.