What is the diagnosis and treatment for Labyrinthitis (inflammation of the inner ear)?

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From the Guidelines

Labyrinthitis should be treated with vestibular suppressants, anti-nausea medications, and rest, with the goal of managing symptoms until the infection resolves, usually within 1-3 weeks, as recommended by the most recent clinical practice guidelines 1.

Diagnosis and Treatment

Labyrinthitis is an inner ear infection that causes inflammation of the labyrinth, a delicate structure responsible for hearing and balance. The diagnosis is based on the clinical presentation of sudden severe vertigo with profound hearing loss and prolonged vertigo, as outlined in Table 5 of the clinical practice guideline 1.

  • Key symptoms include vertigo, nausea, and hearing loss, which are not episodic or fluctuating.
  • Treatment typically involves rest and medications to manage symptoms, such as:
    • Vestibular suppressants like meclizine (25mg every 4-6 hours) or diazepam (2-5mg every 6-8 hours) to reduce vertigo and dizziness.
    • Anti-nausea medications such as promethazine (12.5-25mg every 4-6 hours) or ondansetron (4-8mg every 8 hours) to control nausea and vomiting.
  • If a bacterial infection is suspected, antibiotics may be prescribed, as indicated by the clinical presentation and history of the patient.

Management and Rehabilitation

During recovery, patients should:

  • Avoid sudden head movements to prevent exacerbating the condition.
  • Stay hydrated to help manage symptoms.
  • Gradually increase activity as symptoms improve, to prevent relapse and promote recovery.
  • Vestibular rehabilitation exercises may be recommended for persistent balance problems, to improve balance and reduce the risk of falls. Labyrinthitis occurs when viruses or bacteria infect the inner ear, disrupting the transmission of position and movement information to the brain, which explains the characteristic vertigo, dizziness, and balance problems, as described in the clinical practice guideline 1. Most cases resolve completely, though some patients may experience residual dizziness that improves with time and rehabilitation.

From the Research

Definition and Symptoms of Labyrinthitis

  • Labyrinthitis is an inner ear disorder characterized by sudden hearing loss and concurrent vertigo 2
  • Symptoms at presentation include vestibular weakness, and patients may experience balance problems and activity avoidance behavior

Prognosis of Labyrinthitis

  • Patients with idiopathic labyrinthitis have a poor prognosis for both hearing and balance function impairment 2
  • After a median of 61 months of follow-up, 72.5% of patients still experienced balance problems, and subjective hearing recovery only occurred in 20% of cases 2

Related Studies

  • There are no other relevant studies provided that directly relate to labyrinthitis, except for the study by 2
  • Other studies provided, such as 3 and 4, discuss unrelated topics, including the distribution of membrane-bound monoamine oxidase in bacteria and lipoproteins of special significance in atherosclerosis, respectively

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Idiopathic Labyrinthitis: Symptoms, Clinical Characteristics, and Prognosis.

The journal of international advanced otology, 2023

Research

Distribution of membrane-bound monoamine oxidase in bacteria.

Applied and environmental microbiology, 1979

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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