What is labyrinthitis
Synonym: otitis interna
Under one Labyrinthitis one understands the inflammation of the labyrinth in the inner ear.
2.1 Tympanogenic labyrinthitis
The tympanogenic labyrinthitis occurs in the context of otitis media when it spreads to neighboring structures. It is a serous labyrinthitis in which toxins reach the inner ear through the round and oval window.
2.2 Syphilis labyrinthitis
The syphilis labyrinthitis describes a labyrinthitis in a syphilis in the second or third stage, which is accompanied by syphilitic pleurisy or meningitis.
2.3 Meningogenic labyrinthitis
Meningitis caused by pneumococci or meningococci can also lead to labyrinthitis. The bacteria enter the inner ear via the aqueductus cochleae. Meningogenic labyrinthitis leads to labyrinth failure.
2.4 Viral labyrinthitis
Mumps, zoster oticus and measles can also trigger labyrinthitis.
Borreliosis, Wegener's disease and other autoimmune diseases also lead to labyrinthitis in some cases.
There are essentially two forms of labyrinthitis: on the one hand, circumscribed labyrinthitis (especially in chronic otitis media (cholesteatoma), which leads to erosion of the lateral semicircular canal, and on the other hand, diffuse labyrinthitis (especially as a serous inflammation in acute otitis media).
The affected patients complain of vertigo and vomiting. If only the labyrinth is irritated, there is spontaneous nystagmus on the diseased side; if the labyrinth fails, there is nystagmus on the opposite side. Hearing is decreased.
A complication is the transition into a purulent labyrinthitis. In purulent labyrinthitis, vertigo and vomiting are more pronounced, there is a failure nystagmus to the opposite side and numbness.
There is a risk that the disease will spread through the internal auditory canal (Meatus acousticus internus). Furthermore, labyrinthostitis can develop, which carries the risk of meningitis.
Sensorineural hearing loss can be seen in the audiogram. In order to rule out bony involvement, especially in the case of purulent labyrinthitis, computed tomography or magnetic resonance tomography with gadolinium is performed.
In addition, the vestibular organ should be examined by means of thermal testing and rotational testing.
Depending on the suspected cause, further tests may be necessary (e.g. immune serology).
If labyrinthitis has been around for a short time and is caused by bacteria, antibiotics are prescribed. Antiviral drugs (acyclovir) are administered in viral genesis. Rheologics and corticoids are also helpful.
A mastoidectomy is performed if the labyrinthitis has been present for several days and if the necrosis is advanced, a labyrinthectomy is performed.
If the labyrinthitis occurs as part of Wegener's disease or an autoimmune disease, immunosuppressants are prescribed.
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