It usually affects adults; infants rarely develop this disease. 
Labyrinthitis is not contagious.

 


Anatomy of the labyrinth

The labyrinth is located in the inner ear , that is, the deepest part of this organ.

It is divided into two areas:

  • The cochlea: responsible for hearing,
  • The vestibular system : responsible for balance.

Within the labyrinth there are the organs of balance:

  • The semicircular channels,
  • The utricle,
  • The sacrament.

 

Development of labyrinthitis (physiopathology)

Usually, labyrinthitis affects the upper part of the labyrinth and its afferents (Jeong SH – Department of Neurology, Chungnam National University Hospital, Daejeon, Korea), while the lower part of the vestibular labyrinth is rarely affected. 
Within the semicircular canals there is a fluid called the endolymph that moves based on the movements of the head.

The nerves detect the movement of the fluid and transmit this information to the brain. 
The inner ear is connected to the brain through the vestibular nerve . 
The brain interprets the movement of the fluid and allows to maintain the balance.

The eyes also send information about the position of the head to the brain. 
When information from the labyrinth and the eye does not match, the brain has difficulty interpreting body movement . 
This misinterpretation often causes dizziness or the feeling that the body is moving, when in fact it is stationary.

Fonte: John Simic, MD, Scott H Plantz, MD, Francisco Talavera, PharmD, PhD, Richard Harrigan, MD


Causes of labyrinthitis

The causes of labyrinthitis can be:

Infectious labyrinthitis

The viral and bacterial infections of the upper respiratory tract can cause labyrinthitis. 
Viruses, fungi and bacteria can invade the labyrinth:

  • Through the blood,
  • In case of otitis media , through the oval or round window of the skull (rare).

Viral labyrinthitis
The viruses that most commonly cause labyrinthitis are:

  • Cold viruses ,
  • Herpes zoster (viral labyrinthitis),
  • Mumps,
  • Measles ,
  • Rubella ,
  • Mononucleose.

Bacterial labyrinthitis
In this case there is a serious infection that can evolve in 4 stages:

  • Serosa is an early stage in which inflammation develops and the formation of exudate fluid (inflammatory fluid with high protein concentration ) is rich in antibodies .
  • Purulent or suppurative, it is an acute infection with accumulation of pus consisting of bacteria and antibodies.
  • Fibrous , characterized by the formation of fibrous tissue; occurs in case of chronic infection, a few weeks or months after the onset of acute labyrinthitis. It is characterized by proliferation of fibroblasts in the labyrinth.
  • Ossificans , in this stage the bone tissue accumulates in the labyrinth. Ossification occurs a few months after acute infection.

 

Non-infectious labyrinthitis

Autoimmune labyrinthitis
The immune system produces white blood cells and antibodies to fight infections. 
In an autoimmune disease, the immune system attacks the healthy tissues of the body causing lesions and inflammation. 
Often, the disease affects both ears and patients suffer from autoimmune diseases in other parts of the body.

 

Toxic
labyrinthitis Toxic labyrinthitis is a sterile inflammation (not caused by germs) that can be caused by the chemical irritation of the labyrinth membrane. 
Irritants can usually come from the body, for example:

  • Bacterial toxins,
  • Mediators of inflammatory reactions (substances involved in the inflammatory process),
  • Metabolic products of a tumor in the middle ear, external or temporal bone.

 

Other causes of labyrinthitis

  • Stress ,
  • Alcohol ,
  • Trauma,
  • Allergy ,
  • Some medicines:
    • Furosemide (Lasix)
    • Aspirin
    • Some antibiotics
    • Phenytoin (diphenylhydantoin) at toxic levels

Risk factors for labyrinthitis

Inadequate nutrition, sedentary lifestyle and  smoking favor the appearance of labyrinthitis. 
Foods that may increase the chances of developing labyrinthitis are:

  • Café,
  • Chocolate,
  • will,
  • Sweets,
  • Alcohol.

According to the blood type diet theory , a person may be dizzy if they eat:

  • Cereals with gluten ,
  • Milk and dairy products (cheese, yogurt, etc.)


Symptoms of labyrinthitis

The most common symptoms of labyrinthitis are:

  1. Constant dizziness (or dizziness ) for several days; the person has a sense of “spinning” while the room is standing or the person is standing still but the room “spins” around it,
  2. Hearing loss  in one or both ears,
  3. Nausea or vomiting ,
  4. Loss of balance .

The movements of the head and eyes worsen the symptoms ; in more severe cases the patient should remain in bed still not to vomit.

Labyrinthitis can be:

  • Light,
  • Grave.

Some people feel only slightly dazed and unbalanced; other individuals are unable to stand.

Other symptoms of acute labyrinthitis are as follows:

  • Mild headache ,
  • Tinnitus ( ringing or whistling in the ears ) that may be unilateral or bilateral (in both ears),
  • Feeling sick,
  • Blurred vision,
  • Spontaneous horizontal-rotational nystagmus (Jeong SH – Department of Neurology, Chungnam National University Hospital, Daejeon, Korea.)

The patient may have mood disorders , such as:

 

Chronic labyrinthitis
In rare cases people suffer from dizziness, vertigo and nausea for many months, even years. This condition is called chronic labyrinthitis. 
The symptoms of chronic labyrinthitis are less severe, although dizziness is a problem that should not be underestimated, especially for people driving heavy vehicles.

 


Complications of labyrinthitis

Labyrinthitis often occurs without complications. 
Sometimes this pathology can cause:

  • The permanent loss of hearing ,
  • Damage to the balance system.

The brain compensates for the damage, for example by ignoring the abnormal signals from the diseased ear, but the person feels unstable.

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