The diagnosis of labyrinthitis is made by an otorhinolaryngologist (ENT doctor). In some cases, for a correct diagnosis, they resort to consulting a neurologist and an infectious disease specialist. Labyrinthitis is characterized by the presence of such complaints as:
- dizziness;
- discoordination of movements;
- hearing loss;
- hum in one or both ears.
One of the main signs of labyrinthitis is the fact of involuntary oscillatory eye movements (nystagmus). Having thoroughly collected the necessary information about the disease, the ENT doctor can use a number of different instrumental diagnostic methods. In more detail, the consequences, course, general characteristics and clinic of labyrinthitis are below. You will also learn about the consequences of the disease.
Causes of labyrinthitis
Labyrinthitis is an otolaryngitis disease that develops as a result of infection pathogens entering the anatomical cavity of the inner ear. Modern medicine identifies the following factors contributing to the development of this pathology:
- Chronic inflammatory processes localized in different parts of the ear. Otitis is one of the main reasons for the development of labyrinthitis. The accumulation of purulent masses increases pressure on the eardrum, as a result of which it is damaged, this contributes to the penetration of pathogens into the internal cavity.
- Transferred meningitis of various etiologies. Due to the development of the inflammatory process in the structural membranes of the brain, the risk of developing a pathological process in the anatomical cavity of the ear also increases significantly. This phenomenon can be observed when complications occur during meningitis or due to delayed medical care.
- Injuries. Ear injuries are most typical for children, damage to the structural membranes of the inner ear occurs due to various mechanical damage (cleaning the child's ear without parental control, wounding with sharp foreign objects, injuries during a fall).
- Complication after viral diseases.
Labyrinthitis symptoms
Manifestations of pathology are very spontaneous and acute. Clinical manifestations of the disease are characterized by the presence of such symptoms:
- Pain.
- Presence of purulent discharge.
- Development of vestibular disorders.
- The appearance of impaired coordination of movements manifests itself systematically, the patient has a persistent loss of balance when changing posture.
- The appearance of signs of intoxication of the body. Signs of poisoning are especially frequent during an exacerbation of the chronic form of labyrinthitis.
- Hearing impairment. The accumulation of purulent masses significantly compresses the tympaniceardrum, resulting in temporary hearing loss.
- Tinnitus.
- Appearance of autonomic disorders.
- Nystagmus. It is one of the first signs of the development of inflammation in the inner cavity of the ear. Eye movements are involuntary and become more frequent with the complication of the disease.
- Exacerbation of the symptoms of the disease increases when you try to turn your head.
To eliminate the pathological process, you must immediately consult a doctor, you should not try to treat the disease yourself, as this can significantly aggravate your he alth.
Diagnosis
The following methods for diagnosing labyrinthitis are distinguished:
- Otoscopy is used to examine the auricle, behind the ear zone of the external auditory canal (together with the mastoid process) and the tympanic membrane. In addition, the doctor will certainly probe all the lymph nodes close to the external auditory canal for their enlargement.
- Vestibulometry involves the use of various studies to identify pathological modifications of the vestibular aggregate. The analysis of these methods is done on the basis of the duration and type of nystagmus. It should be noted that vestibulometry is considered only an additional method and is used in combination with other methods for diagnosing labyrinthitis.
- Audiometry is a method of examining hearing acuity and determining auditory susceptibility to sound waves. This method is carried out using a special technique - an audiometer. It should be noted that audiometry requires a specialized soundproof room.
- Electronystagmography is considered a method that makes it possible to quantitatively and qualitatively evaluate nystagmus that appears with labyrinthitis. This method is based on registering the electrical potential difference between the cornea and the retina. The acquired information is recorded on a magnetic tape and subsequently processed by a computer, which makes it possible to establish various characteristics of nystagmus. The result of electronystagmometry makes it possible to distinguish nystagmus caused by the pathology of the vestibular apparatus from other types of nystagmus.
Consequences
Labyrinthitis is an inflammation that develops in the inner ear. The disease disrupts the activity of vestibular receptors and hearing organs. With untimely and improper treatment, labyrinthitis can cause quite serious he alth consequences. The inflammatory process from the inner part of the ear can quickly move to the neighboring organs of hearing, which threatens with possible complications of purulent labyrinthitis:
- Mastoiditis, in which the temporal bone becomes infected.
- Sensory hearing loss is a non-communicable disease that is accompanied by impaired functioning of the hearing organs.
- Petrositis - the inflammatory process affects the pyramid of the temporal bone.
- Encephalitis and meningitis are the most dangerous conditions that affect the lining of the brain.
- Brain abscess is a complicationlabyrinthitis, which is difficult to cure, and if not detected in time, it often leads to the death of the patient.
The highest risk of labyrinthitis complications lies in wait for children who have weak immune systems. In order to prevent an unpleasant outcome of this disease, you need to see a doctor as soon as possible, at the first sign of illness. Proper treatment and diagnosis are the components of a complete recovery without consequences! Labyrinthitis is a dangerous disease and should not be left unattended.
Treatment
Labyrinthitis is bacterial, viral and fungal. Antibiotics are used to treat the bacterial form.
Amoxicillin
One of the universal antibiotics in the treatment of labyrinthitis is "Amoxicillin". It has bactericidal and antibacterial properties. The drug is taken three times a day, after meals, is released according to the prescription of the attending physician. The antibiotic is taken for seven days. The drug can cause allergic reactions, so it should be taken with caution. Available in suspensions, tablets and capsules, thus, it can be easily taken by patients of any age. The drug should not be taken by asthmatics.
Ampicillin trihydrate
"Ampicillin trihydrate" is an antibacterial agent from the penicillin group. Available in the form of capsules, powder and tablets. It is characterized by fast action, to the patientget better in a couple of hours. It is not recommended to take during pregnancy and kidney failure. It is allowed to apply to children who have reached the age of four. It is not recommended to take with other drugs due to the possible appearance of a skin rash. The antibiotic can cause allergic reactions, diarrhea, headaches, and anaphylactic shock.
Ciprofloxacin
Another universal antibiotic is "Ciprofloxacin" from the fluoroquinol group. It is popular among medical specialists. It is forbidden to be taken by pregnant women and children. The drug is characterized by a rapid effect. The drug causes insomnia, fatigue, diarrhea, hives, nausea, dizziness and tachycardia.
Netilmicin
Another antibacterial drug is "Netilmicin" from the aminoglycoside group. It is applied by local ear injections. Treatment is prescribed by the attending physician, and it varies from one to two weeks. May cause allergies. The drug should not be taken by pregnant women, the elderly and during lactation.
Has a huge list of side effects, including disorders of the central nervous system, digestive organs, kidneys, liver and cardiovascular system.
The listed drugs fight infection, relieve inflammation, reduce intoxication, relieve vomiting, nausea, dizziness, improve blood flow. Medicines are prescribed by a doctor. It is not worth self-medicating with labyrnititis, because if you don’t knowcharacteristics of individual drugs can cause serious harm to the body.
Dehydration Therapy
It aims to reduce swelling and reduce pressure inside the labyrinth. For this purpose, diuretics, glucocorticosteroids, hypertonic solutions (glucose, magnesium sulfate, calcium chloride) are prescribed. A s alt and fluid restricted diet is also required.
Surgical treatment
Indication for surgical intervention in labyrinthitis is a number of different pathologies and complications:
- Irreversible hearing loss occurs with acute or chronic injury. Also, deafness can occur with a fracture of the temporal bone due to damage to the structures of the labyrinth and the auditory nerve. In this case, having a hearing restoration procedure can help patients regain their hearing.
- Purulent labyrinthitis leads to an absolute defeat of Corti's organ. In the future, purulent inflammation will lead to necrotic labyrinthitis, which is expressed by the alternation of dead (necrotic) areas of soft tissue and the bone part of the labyrinth together with foci of purulent inflammation.
- Combination of labyrinthitis with inflammation of other bone structures of the temporal bone. This means that inflammation can destroy not only the labyrinth, but also the surrounding bony segments of the temporal bone. Mastoiditis or petrositis is usually treated with surgery (a procedure to remove purulent sources).
- The penetration of the virus from the cavity of the inner ear into the brain. One of the complicationslabyrinthitis is considered to be the spread of the inflammatory process along the course of the auditory nerve to the brain. In this case, meningitis, meningoencephalitis (inflammation of the substance of the brain and membranes) or brain abscess (accumulation of pus) may appear.
Operation techniques
Today, there are a huge number of different techniques and options for surgical opening of the inner ear cavity. In any case, the doctor (otosurgeon) chooses a more optimal technique.
To access the labyrinth, it is allowed to use the appropriate techniques:
- Ginsberg method.
- Neumann method.
At the beginning of the procedure, regardless of the method used, a general cavity (extended) operation is performed. The main task is to eliminate the outer part of the tympanic cavity and gain access to the oval and round window of the middle ear. After surgery for labyrinthitis, the wound is usually packed loosely and left open.
Ginsberg method
The labyrinth is opened in the area of the cochlea and vestibule from the edge of the lateral (horizontal) semicircular canal. An autopsy is done with a special surgical chisel in the area that corresponds to the main coil of the cochlea. Surgical manipulations should be clearly carried out, since if the chisel jumps to the oval window under the blow of a hammer, this will lead to a defect in the facial nerve. Also nearby is the area of the internal carotid artery, which can also be easily damaged. At the 2nd stage, an opening of the horizontal semicircular canal is made. Then, through this path, a special spoon is used to scrape the vestibule and passagessnails.
Neumann method
This method is considered the most constructive, since not one, but 2 semicircular canals (external and lateral) are opened at the same time. After these channels have been opened, the cochlea is scraped. This method is much more difficult than the Ginsberg method, however, it makes it possible to better perform drainage of the labyrinth (outflow of pathological secretion from the cavity of the inner ear).
