Labyrinthitis is thought to be the result of an inner ear viral infection. It affects the balance nerve and causes inflammation of the hearing nerve and/or cochlea. Rarely, labyrinthitis can also be due to a bacterial ear infection. Mild hearing loss to complete deafness can result from this condition. The symptoms of labyrinthitis are similar to those of vestibular neuritis but the latter affects the vestibular nerve and does not result in hearing loss. Differentiating one from the other is done with a microscopic examination of the middle ear.

Symptoms of labyrinthitis typically include the acute onset of vertigo that can last hours to days and can be accompanied by nausea, vomiting, and imbalance. Hearing loss often occurs concurrently with vertigo or shortly after, and can be accompanied by loud tinnitus, pressure, or pain in the ear. These symptoms frequently occur following another illness such as an upper respiratory infection, ear infection or the flu.

Acute labyrinthitis is treated similarly to vestibular neuritis unless there is evidence of a middle ear infection (otitis media). Due to the acute loss of hearing, steroids are typically prescribed to prevent more hearing loss and to salvage that which has already occurred. In cases where the hearing does not improve following oral steroid therapy, further treatments such as transtympanic steroid injections or diuretics may be indicated on a case-by-case basis. Should the hearing continue to fluctuate or the vertigo episodes recur, other diagnoses such as Meniere’s disease or vestibular migraine should be considered.

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