labyrinthitis

Labyrinthitis is an inflammatory disorder of the inner ear labyrinth that disrupts balance and hearing. It typically begins with abrupt vertigo lasting days to weeks, accompanied by nausea, imbalance, and unilateral sensorineural hearing loss, often with tinnitus or a feeling of fullness. It differs from vestibular neuritis by cochlear involvement and hearing impairment.

Causes are most commonly viral or postinfectious in origin. Bacterial labyrinthitis is rarer and more serious. Inflammation affects the cochlear and vestibular structures, which can produce lasting hearing or balance problems.

Diagnosis relies on clinical history and examination, supported by audiometry showing unilateral sensorineural hearing loss. Vestibular testing and magnetic resonance imaging can help exclude stroke, central causes of vertigo, or other structural problems. The diagnosis is often one of exclusion after ruling out more dangerous etiologies.

Treatment focuses on symptom relief and rehabilitation. In the acute phase, antiemetics and, when needed, vestibular suppressants may help with motion symptoms. Treat underlying infection if identified; antibiotics are used for suspected bacterial involvement. The role of corticosteroids is uncertain and not routinely recommended. Vestibular rehabilitation therapy aids compensatory recovery, and many patients improve over weeks to months, though some have persistent dizziness or hearing loss.

Prognosis is generally favorable, with most individuals improving over time. The extent of cochlear involvement largely determines residual deficits, and recurrence is uncommon.