From the Guidelines
Labyrinthitis should be treated with rest, anti-vertigo medications like meclizine (25mg every 4-6 hours as needed), antiemetics such as ondansetron (4-8mg every 8 hours) for nausea, and sometimes vestibular suppressants like diazepam (2-5mg every 8 hours) for severe symptoms, as most cases resolve within 1-3 weeks with proper management 1.
Key Considerations
- The condition typically presents with vertigo, hearing loss, and balance problems, and patients should avoid sudden movements, stay hydrated, and gradually increase activity as symptoms improve.
- Vestibular rehabilitation exercises may help speed recovery by retraining the brain to compensate for balance issues.
- Bacterial labyrinthitis requires antibiotics and can cause permanent hearing damage if not treated promptly, so patients should seek immediate medical attention if symptoms are severe or accompanied by high fever, severe headache, or changes in vision or consciousness.
Diagnosis and Treatment
- A thorough otologic history and physical examination should be performed to evaluate for neurologic, other neurotologic/otologic, oncologic, inflammatory, or infectious or vascular causes 1.
- The patient's symptoms and medical history should be carefully evaluated to determine the best course of treatment, and long-term follow-up is recommended to monitor for any underlying causes or persistent symptoms 1.
Quality of Life
- Labyrinthitis can significantly impact a patient's quality of life, causing vertigo, hearing loss, and balance problems, and treatment should aim to alleviate these symptoms and improve overall well-being 1.
- Vestibular rehabilitation exercises and other therapies may be necessary to help patients recover from labyrinthitis and regain their balance and mobility.
From the Research
Definition and Causes of Labyrinthitis
- Labyrinthitis is an inner ear disorder characterized by sudden hearing loss and concurrent vertigo 2
- The exact incidence of labyrinthitis is unknown 2
- It can be caused by various factors, including viral, bacterial, or autoimmune pathogenesis, but in some cases, the cause is idiopathic 2
Symptoms and Clinical Characteristics
- Symptoms of labyrinthitis include sudden hearing loss and vertigo 2
- Vestibular weakness is a common finding in patients with labyrinthitis 2
- Patients with idiopathic labyrinthitis often experience persistent balance problems and activity avoidance behavior 2
Treatment and Prognosis
- The treatment of vertigo, a symptom of labyrinthitis, can be tailored to the specific cause, with classes of medications including anticholinergics, antihistamines, benzodiazepines, calcium channel antagonists, and dopamine receptor antagonists 3
- In cases of idiopathic labyrinthitis, the prognosis for both hearing and balance function impairment is poor, with 72.5% of patients still experiencing balance problems after a median of 61 months of follow-up 2
- Subjective hearing recovery only occurred in 20% of cases 2