What are the main causes of labyrinthitis. How does labyrinthitis affect balance and hearing. What are the key symptoms of labyrinthitis. How is labyrinthitis diagnosed and treated. Can labyrinthitis resolve on its own.

Understanding Labyrinthitis: An Overview of Inner Ear Infection

Labyrinthitis is an inner ear infection that can significantly impact a person’s balance and hearing. This condition occurs when an infection, typically viral or bacterial, spreads to the inner ear, also known as the labyrinth. The labyrinth plays a crucial role in both auditory processing and maintaining equilibrium, making labyrinthitis a potentially disruptive and concerning health issue.

The Structure and Function of the Inner Ear

To fully grasp the implications of labyrinthitis, it’s essential to understand the inner ear’s anatomy. The labyrinth consists of two main components:

• The cochlea: A small, snail-shaped structure responsible for converting sound vibrations into nerve impulses that the brain can interpret.
• The vestibular system: A complex network of semicircular canals that provide information about the body’s spatial orientation, crucial for maintaining balance.

Both these structures communicate with the brain via the vestibulocochlear nerve, transmitting vital sensory information. When labyrinthitis occurs, the inflammation disrupts this communication, leading to various symptoms.

Causes and Risk Factors of Labyrinthitis

Labyrinthitis can be triggered by various factors, with viral infections being the most common cause. However, bacterial infections can also lead to this condition, often resulting in more severe symptoms. Understanding the potential causes and risk factors can help in prevention and early detection.

Common Causes of Labyrinthitis

• Upper respiratory infections (e.g., common cold, flu)
• Middle ear infections
• Meningitis
• Head injuries
• Respiratory illnesses (e.g., bronchitis)
• Viral infections (e.g., herpes, measles)
• Autoimmune conditions

Risk Factors for Developing Labyrinthitis

While anyone can develop labyrinthitis, certain factors may increase the likelihood of its occurrence:

• Smoking
• Heavy alcohol consumption
• History of allergies
• Chronic stress
• Use of specific medications

Is there a way to prevent labyrinthitis? While it’s not always possible to prevent labyrinthitis, maintaining good overall health, managing stress, and avoiding excessive alcohol consumption can help reduce the risk. Additionally, promptly treating upper respiratory infections and middle ear infections may prevent them from spreading to the inner ear.

Recognizing the Symptoms of Labyrinthitis

Labyrinthitis symptoms can appear suddenly and without warning, ranging from mild discomfort to severe disruption of daily activities. The duration of symptoms can vary, with some individuals experiencing relief within a few weeks, while others may face long-term or recurring issues.

Key Symptoms of Labyrinthitis

• Dizziness
• Vertigo (sensation of spinning)
• Tinnitus (ringing in the ears)
• Nausea
• Loss of balance
• Hearing problems
• Vision disturbances

How does vertigo differ from general dizziness in labyrinthitis? Vertigo, a hallmark symptom of labyrinthitis, is characterized by a sensation of spinning or the environment moving around you. This is distinct from general dizziness, which may feel more like lightheadedness or unsteadiness. Vertigo in labyrinthitis can be particularly intense and may be accompanied by nausea and difficulty maintaining balance.

Types of Labyrinthitis: Viral vs. Bacterial

Labyrinthitis can be classified into different types based on its underlying cause. Understanding these distinctions is crucial for proper diagnosis and treatment.

Viral Labyrinthitis

Viral labyrinthitis is the most common form of the condition. It typically results from viral infections such as colds or flu spreading to the inner ear. Characteristics of viral labyrinthitis include:

• Sudden onset of vertigo
• Nausea and vomiting
• Possible hearing loss
• Generally resolves on its own
• Treatment focuses on symptom relief

Bacterial Labyrinthitis

Bacterial labyrinthitis is less common but often more severe than its viral counterpart. It can be further categorized into two types:

1. Serous Labyrinthitis (Toxic Labyrinthitis)
   • Often results from chronic otitis media (COM)
   • Affects high-frequency hearing
   • Symptoms include mild vertigo and nausea
2. Suppurative Labyrinthitis
   • Occurs when bacteria from the middle ear enter the inner ear
   • More severe symptoms, typically affecting one ear
   • Can lead to severe vertigo, tinnitus, and hearing loss

Why is distinguishing between viral and bacterial labyrinthitis important? The distinction is crucial because the treatment approaches differ significantly. While viral labyrinthitis often resolves on its own with symptomatic treatment, bacterial labyrinthitis typically requires antibiotic therapy to prevent complications and permanent damage to the inner ear.

Diagnosis and Medical Assessment of Labyrinthitis

Diagnosing labyrinthitis can be challenging as there are no specific tests for the condition. However, a thorough medical assessment is essential for proper diagnosis and treatment.

Diagnostic Process

• Comprehensive physical examination
• Detailed medical history review
• Neurological evaluation
• Hearing tests
• Balance assessment

What conditions might be mistaken for labyrinthitis? Several conditions can present with similar symptoms to labyrinthitis, including:

• Benign paroxysmal positional vertigo (BPPV)
• Vestibular neuritis
• Ménière’s disease
• Acoustic neuroma
• Migraines with vestibular symptoms

A thorough diagnostic process helps differentiate labyrinthitis from these conditions, ensuring appropriate treatment.

When to Seek Medical Attention

It’s crucial to consult a healthcare provider as soon as symptoms of labyrinthitis appear. Even if the condition may resolve on its own, professional assessment is important to:

• Determine the underlying cause (viral or bacterial)
• Prevent potential complications
• Assess any permanent damage
• Receive appropriate treatment, especially for bacterial cases

Treatment Approaches for Labyrinthitis

The treatment of labyrinthitis varies depending on its cause and severity. The primary goals are to address the underlying infection, manage symptoms, and prevent complications.

Treatment for Viral Labyrinthitis

• Symptomatic treatment (e.g., anti-nausea medications, vestibular suppressants)
• Rest and hydration
• Vestibular rehabilitation exercises
• Gradual return to normal activities

Treatment for Bacterial Labyrinthitis

• Antibiotic therapy
• Corticosteroids to reduce inflammation
• Symptomatic treatment as needed
• Possible surgical intervention in severe cases

How effective are vestibular rehabilitation exercises in treating labyrinthitis? Vestibular rehabilitation exercises can be highly effective in managing the balance and dizziness symptoms associated with labyrinthitis. These exercises help the brain compensate for the altered signals from the inner ear, improving balance and reducing vertigo over time. However, the effectiveness can vary among individuals, and it’s important to perform these exercises under the guidance of a trained professional.

Long-Term Outlook and Potential Complications of Labyrinthitis

While many cases of labyrinthitis resolve without long-term effects, some individuals may experience persistent symptoms or complications. Understanding the potential long-term impact is crucial for managing expectations and seeking appropriate care.

Potential Long-Term Effects

• Chronic dizziness or balance problems
• Persistent tinnitus
• Partial or complete hearing loss
• Increased risk of falls, especially in older adults
• Emotional distress or anxiety related to symptoms

Preventing Complications

To minimize the risk of long-term complications from labyrinthitis, consider the following:

• Seek prompt medical attention at the onset of symptoms
• Adhere to prescribed treatment plans
• Participate in vestibular rehabilitation if recommended
• Make necessary lifestyle modifications to support recovery
• Attend follow-up appointments to monitor progress

Can labyrinthitis recur after initial recovery? While not common, labyrinthitis can recur in some individuals. Factors that may increase the risk of recurrence include:

• Compromised immune system
• Chronic ear infections
• Underlying autoimmune conditions
• Exposure to the same viral or bacterial triggers

Maintaining good overall health and promptly addressing any ear or upper respiratory infections can help reduce the risk of recurrence.

Living with Labyrinthitis: Coping Strategies and Lifestyle Adjustments

Adapting to life with labyrinthitis, especially during the acute phase or in cases of chronic symptoms, can be challenging. Implementing effective coping strategies and making appropriate lifestyle adjustments can significantly improve quality of life.

Practical Coping Strategies

• Create a safe home environment to prevent falls
• Use assistive devices for balance if necessary
• Practice stress-reduction techniques (e.g., meditation, deep breathing)
• Maintain a consistent sleep schedule
• Avoid triggers that exacerbate symptoms (e.g., certain head movements, visual stimuli)

Lifestyle Adjustments

Making certain lifestyle changes can support recovery and manage ongoing symptoms:

• Dietary modifications (e.g., reducing salt and caffeine intake)
• Regular, gentle exercise to improve overall balance and strength
• Limiting alcohol consumption
• Quitting smoking
• Adopting a balanced, nutrient-rich diet to support immune function

How can individuals with labyrinthitis maintain their mental health? Living with labyrinthitis can be emotionally challenging, potentially leading to anxiety or depression. To maintain mental health:

• Seek support from friends, family, or support groups
• Consider counseling or therapy to address emotional impacts
• Practice mindfulness and relaxation techniques
• Set realistic goals and celebrate small victories in recovery
• Stay informed about the condition to reduce uncertainty and fear

By addressing both the physical and emotional aspects of labyrinthitis, individuals can better navigate the challenges posed by this condition and improve their overall quality of life.

Causes, symptoms, treatment, and recovery

Labyrinthitis is an inner ear infection that can affect a person’s balance and hearing. It may occur when a cold, the flu, or a middle ear infection spreads to the inner ear.

This article will cover the causes, symptoms, diagnosis, and treatment of labyrinthitis.

The inner ear, also known as the labyrinth, is responsible for both hearing and balance. The labyrinth consists of two main parts:

• The cochlea is a small, snail-shaped structure that converts sound vibrations into nerve impulses that travel to the brain.
• The vestibular system consists of a complex network of semicircular canals that play an important role in maintaining balance by providing information about the body’s spatial orientation.

Both the cochlea and vestibular system send information to the brain via the vestibulocochlear nerve.

Labyrinthitis is an infection of the inner ear. It causes inflammation that can affect the structures of this part of the ear and disrupt the flow of sensory information from the ear to the brain. This disruption can result in a range of symptoms, including dizziness, vertigo, and even hearing loss.

Viral infections are the most common cause of labyrinthitis, but the condition can sometimes result from a bacterial infection.

While both types of infection can cause similar symptoms, bacterial labyrinthitis is generally more severe than viral labyrinthitis. The treatments for the two are very different, so it is important that a person gets the correct diagnosis from a doctor.

Anyone can develop labyrinthitis, but some conditions can increase the risk. These include:

• upper respiratory infections, such as the common cold and the flu
• middle ear infections
• meningitis
• head injuries
• respiratory illnesses, such as bronchitis
• viral infections, including herpes and measles
• autoimmune conditions

Other factors that may increase the likelihood of labyrinthitis include:

• smoking
• heavy alcohol consumption
• a history of allergies
• stress
• use of specific medications

Share on PinterestSymptoms of labyrinthitis can include tinnitus, hearing problems, dizziness, and nausea.

The symptoms of labyrinthitis can appear suddenly and without warning. Some people with this infection may experience symptoms that last for a few weeks but then disappear on their own.

However, other people may experience long-term or reoccurring symptoms that appear when they move their head suddenly.

Symptoms of labyrinthitis include:

• dizziness
• vertigo, which gives a person the sensation of spinning or the world spinning around them
• tinnitus, which is ringing in the ears
• nausea
• loss of balance
• hearing or vision problems

There are several different types of labyrinthitis, which we cover in more detail below.

Viral labyrinthitis

Most cases of labyrinthitis are due to viral infections, such as a cold or the flu, spreading to the inner ear. Viral labyrinthitis typically results in sudden vertigo, nausea, and vomiting. Sometimes, it also leads to hearing loss.

Viral labyrinthitis usually goes away on its own. Medications for this form of labyrinthitis aim to relieve symptoms, such as dizziness and nausea.

Bacterial labyrinthitis

There are two main types of bacterial labyrinthitis:

Serous labyrinthitis

Also called toxic labyrinthitis, serous labyrinthitis commonly results from a bacterial infection in the middle ear, which doctors refer to as chronic otitis media (COM). COM causes a fluid buildup in the middle ear, which can progress to the inner ear if a person does not receive treatment.

Serous labyrinthitis is the less severe type of bacterial labyrinthitis, and hearing loss only affects high-frequency sounds. The symptoms of serous labyrinthitis include:

• mild vertigo
• nausea or vomiting

Suppurative labyrinthitis

This form of labyrinthitis occurs when bacteria in the middle ear enter the inner ear. The symptoms are more severe than those of serous labyrinthitis, and they typically affect just one of the ears.

Symptoms of suppurative labyrinthitis include:

• severe vertigo
• nausea and vomiting
• tinnitus
• nystagmus, which is a condition that causes repetitive and uncontrolled eye movements
• hearing loss

A person should see a doctor as soon as any symptoms of labyrinthitis appear. Labyrinthitis can resolve without treatment, but determining the cause of the condition is key to preventing long-lasting complications.

A doctor can determine whether a viral or bacterial infection is responsible for the symptoms. They may prescribe antibiotics for bacterial labyrinthitis.

Even if the labyrinthitis clears on its own, it is a good idea to ask a doctor to assess whether or not the condition has caused any permanent damage.

There are no specific tests to diagnose labyrinthitis. A doctor will usually carry out a thorough physical examination and neurological evaluation to rule out any other conditions, such as:

Rarely, structural abnormalities inside a person’s head can cause symptoms of labyrinthitis. To rule these out, a doctor may recommend imaging tests, such as a CT or MRI scan.

Share on PinterestOver-the-counter antihistamines may ease some of the symptoms of viral labyrinthitis.

The purpose of labyrinthitis treatment is to relieve symptoms. A person can take over-the-counter antihistamines to ease some of the symptoms of viral labyrinthitis, such as nausea or dizziness. Stronger antihistamines, such as meclizine or promethazine, are available on prescription.

A doctor may also prescribe corticosteroids or sedatives for people with more severe symptoms. In cases where a bacterial infection is responsible for labyrinthitis, they may prescribe antibiotics.

If symptoms persist for several months, the doctor may need to check the individual for signs of permanent hearing damage. Following this, they can advise on whether or not a hearing aid may be helpful.

When labyrinthitis is chronic, or long-term, a person may benefit from a type of physical therapy called vestibular rehabilitation. This therapy involves exercises that aim to improve balance and reduce dizziness.

Therapists typically tailor vestibular rehabilitation to an individual’s specific needs, but some common exercises include:

• moving the eyes up and down and from side to side
• bending the head forward and backward
• turning the head from side to side
• bending the torso forward
• leaning the torso over to each side
• catching and throwing a ball
• walking up and down on an incline

Most people can perform vestibular rehabilitation exercises at home, but a specialized physical therapist will monitor their progress and make any necessary modifications to the exercises.

Early diagnosis and treatment of labyrinthitis can reduce the risk of permanent damage to the inner ear. Severe cases of labyrinthitis can result in permanent damage to the vestibular system and varying degrees of hearing loss.

Labyrinthitis can also lead to a condition known as benign paroxysmal positional vertigo (BPPV). BPPV is a type of vertigo that results from sudden movements of the head. This condition is not life-threatening, but it can increase a person’s risk of falls.

Labyrinthitis is not life-threatening. In most cases, hearing and balance return to normal over time. Symptoms of vertigo and dizziness usually only last for a few days.

Most people make a full recovery provided that they receive proper treatment, especially for bacterial labyrinthitis. Recovery from labyrinthitis usually takes a few weeks.

While recovering from labyrinthitis, a person should rest and avoid any sudden movements of the head. As this condition can significantly affect a person’s balance and coordination, it is also essential to avoid driving and operating potentially dangerous machinery.

During a vertigo attack, a person should try to remain calm and avoid unnecessary movement. It is best to avoid bright lights and television or computer screens during an attack. Instead, find a quiet place to sit down and wait for it to pass.

People who experience chronic labyrinthitis should speak with their doctor about other treatment options, such as vestibular rehabilitation.

Labyrinthitis is an infection of the inner ear that can cause nausea and affect a person’s balance and hearing. Although symptoms typically resolve on their own within a few weeks, it is important to see a doctor for a proper evaluation.

A doctor can prescribe medications to relieve symptoms and aid recovery. In severe cases, untreated labyrinthitis can lead to serious long-term health complications, such as permanent damage to the inner ear and hearing loss.

Causes, symptoms, treatment, and recovery

Labyrinthitis is an inner ear infection that can affect a person’s balance and hearing. It may occur when a cold, the flu, or a middle ear infection spreads to the inner ear.

This article will cover the causes, symptoms, diagnosis, and treatment of labyrinthitis.

The inner ear, also known as the labyrinth, is responsible for both hearing and balance. The labyrinth consists of two main parts:

• The cochlea is a small, snail-shaped structure that converts sound vibrations into nerve impulses that travel to the brain.
• The vestibular system consists of a complex network of semicircular canals that play an important role in maintaining balance by providing information about the body’s spatial orientation.

Both the cochlea and vestibular system send information to the brain via the vestibulocochlear nerve.

Labyrinthitis is an infection of the inner ear. It causes inflammation that can affect the structures of this part of the ear and disrupt the flow of sensory information from the ear to the brain. This disruption can result in a range of symptoms, including dizziness, vertigo, and even hearing loss.

Viral infections are the most common cause of labyrinthitis, but the condition can sometimes result from a bacterial infection.

While both types of infection can cause similar symptoms, bacterial labyrinthitis is generally more severe than viral labyrinthitis. The treatments for the two are very different, so it is important that a person gets the correct diagnosis from a doctor.

Anyone can develop labyrinthitis, but some conditions can increase the risk. These include:

• upper respiratory infections, such as the common cold and the flu
• middle ear infections
• meningitis
• head injuries
• respiratory illnesses, such as bronchitis
• viral infections, including herpes and measles
• autoimmune conditions

Other factors that may increase the likelihood of labyrinthitis include:

• smoking
• heavy alcohol consumption
• a history of allergies
• stress
• use of specific medications

Share on PinterestSymptoms of labyrinthitis can include tinnitus, hearing problems, dizziness, and nausea.

The symptoms of labyrinthitis can appear suddenly and without warning. Some people with this infection may experience symptoms that last for a few weeks but then disappear on their own.

However, other people may experience long-term or reoccurring symptoms that appear when they move their head suddenly.

Symptoms of labyrinthitis include:

• dizziness
• vertigo, which gives a person the sensation of spinning or the world spinning around them
• tinnitus, which is ringing in the ears
• nausea
• loss of balance
• hearing or vision problems

There are several different types of labyrinthitis, which we cover in more detail below.

Viral labyrinthitis

Most cases of labyrinthitis are due to viral infections, such as a cold or the flu, spreading to the inner ear. Viral labyrinthitis typically results in sudden vertigo, nausea, and vomiting. Sometimes, it also leads to hearing loss.

Viral labyrinthitis usually goes away on its own. Medications for this form of labyrinthitis aim to relieve symptoms, such as dizziness and nausea.

Bacterial labyrinthitis

There are two main types of bacterial labyrinthitis:

Serous labyrinthitis

Also called toxic labyrinthitis, serous labyrinthitis commonly results from a bacterial infection in the middle ear, which doctors refer to as chronic otitis media (COM). COM causes a fluid buildup in the middle ear, which can progress to the inner ear if a person does not receive treatment.

Serous labyrinthitis is the less severe type of bacterial labyrinthitis, and hearing loss only affects high-frequency sounds. The symptoms of serous labyrinthitis include:

• mild vertigo
• nausea or vomiting

Suppurative labyrinthitis

This form of labyrinthitis occurs when bacteria in the middle ear enter the inner ear. The symptoms are more severe than those of serous labyrinthitis, and they typically affect just one of the ears.

Symptoms of suppurative labyrinthitis include:

• severe vertigo
• nausea and vomiting
• tinnitus
• nystagmus, which is a condition that causes repetitive and uncontrolled eye movements
• hearing loss

A person should see a doctor as soon as any symptoms of labyrinthitis appear. Labyrinthitis can resolve without treatment, but determining the cause of the condition is key to preventing long-lasting complications.

A doctor can determine whether a viral or bacterial infection is responsible for the symptoms. They may prescribe antibiotics for bacterial labyrinthitis.

Even if the labyrinthitis clears on its own, it is a good idea to ask a doctor to assess whether or not the condition has caused any permanent damage.

There are no specific tests to diagnose labyrinthitis. A doctor will usually carry out a thorough physical examination and neurological evaluation to rule out any other conditions, such as:

Rarely, structural abnormalities inside a person’s head can cause symptoms of labyrinthitis. To rule these out, a doctor may recommend imaging tests, such as a CT or MRI scan.

Share on PinterestOver-the-counter antihistamines may ease some of the symptoms of viral labyrinthitis.

The purpose of labyrinthitis treatment is to relieve symptoms. A person can take over-the-counter antihistamines to ease some of the symptoms of viral labyrinthitis, such as nausea or dizziness. Stronger antihistamines, such as meclizine or promethazine, are available on prescription.

A doctor may also prescribe corticosteroids or sedatives for people with more severe symptoms. In cases where a bacterial infection is responsible for labyrinthitis, they may prescribe antibiotics.

If symptoms persist for several months, the doctor may need to check the individual for signs of permanent hearing damage. Following this, they can advise on whether or not a hearing aid may be helpful.

When labyrinthitis is chronic, or long-term, a person may benefit from a type of physical therapy called vestibular rehabilitation. This therapy involves exercises that aim to improve balance and reduce dizziness.

Therapists typically tailor vestibular rehabilitation to an individual’s specific needs, but some common exercises include:

• moving the eyes up and down and from side to side
• bending the head forward and backward
• turning the head from side to side
• bending the torso forward
• leaning the torso over to each side
• catching and throwing a ball
• walking up and down on an incline

Most people can perform vestibular rehabilitation exercises at home, but a specialized physical therapist will monitor their progress and make any necessary modifications to the exercises.

Early diagnosis and treatment of labyrinthitis can reduce the risk of permanent damage to the inner ear. Severe cases of labyrinthitis can result in permanent damage to the vestibular system and varying degrees of hearing loss.

Labyrinthitis can also lead to a condition known as benign paroxysmal positional vertigo (BPPV). BPPV is a type of vertigo that results from sudden movements of the head. This condition is not life-threatening, but it can increase a person’s risk of falls.

Labyrinthitis is not life-threatening. In most cases, hearing and balance return to normal over time. Symptoms of vertigo and dizziness usually only last for a few days.

Most people make a full recovery provided that they receive proper treatment, especially for bacterial labyrinthitis. Recovery from labyrinthitis usually takes a few weeks.

While recovering from labyrinthitis, a person should rest and avoid any sudden movements of the head. As this condition can significantly affect a person’s balance and coordination, it is also essential to avoid driving and operating potentially dangerous machinery.

During a vertigo attack, a person should try to remain calm and avoid unnecessary movement. It is best to avoid bright lights and television or computer screens during an attack. Instead, find a quiet place to sit down and wait for it to pass.

People who experience chronic labyrinthitis should speak with their doctor about other treatment options, such as vestibular rehabilitation.

Labyrinthitis is an infection of the inner ear that can cause nausea and affect a person’s balance and hearing. Although symptoms typically resolve on their own within a few weeks, it is important to see a doctor for a proper evaluation.

A doctor can prescribe medications to relieve symptoms and aid recovery. In severe cases, untreated labyrinthitis can lead to serious long-term health complications, such as permanent damage to the inner ear and hearing loss.

Labyrinthitis Medical Definition | Merriam-Webster Medical Dictionary

lab·​y·​rin·​thi·​tis

| \ ˌlab-ə-rin-ˈthīt-əs

\

: inflammation of the labyrinth of the inner ear

— called also
otitis interna

Labyrinthitis – an overview | ScienceDirect Topics

Schwere Komplikationen

Otogene Labyrinthitis. Grundsätzlich kann eine Labyrinthitis auf hämatogenem, tympanogenem oder meningealem Weg übertragen werden. Bei der im Rahmen einer chronischen Otitis media seltenen tympanogenen Labyrinthitis ist die Entzündung aus der Paukenhöhle auf das Innenohr übergegangen. Man unterscheidet unter den tympanogenen Infektionen eine

•

akute toxische (seröse) Labyrinthitis,

•

akute eitrige Labyrinthitis,

•

chronische Labyrinthitis.

Die akute toxische Labyrinthitis entsteht durch plötzliches Eindringen von bakteriellen Toxinen über die Rundfenstermembran, über eine Bogengangsfistel oder über den arrodierten Knochen der Cochlea mit freiliegendem Perilymphschlauch. Die klinische Symptomatik besteht in einer peripheren Vestibularisstörung, gekennzeichnet durch einen Reiz- bzw. im weiteren Verlauf Ausfallnystagmus und einer akuten Innenohrschwerhörigkeit. Je nach Lokalisation der Eintrittspforte und Toxinmenge kann der Schweregrad des klinischen Erscheinungsbildes variieren. Allgemein ist die Symptomatik bei der akuten toxischen Labyrinthitis langsamer verlaufend als bei der akuten eitrigen Labyrinthitis.

Bei der akuten eitrigen Labyrinthitis kommt es durch den direkten Übertritt von Bakterien zur Innenohrinfektion mit heftigen Schwindelerscheinungen und rascher Ertaubung. Darüber hinaus besteht bei der bakteriellen Labyrinthitis die Gefahr der Überleitung der Infektion über den inneren Gehörgang oder den Aquaeductus cochleae mit den Folgen der diffusen Meningitis oder des Hirnabszesses. In jedem Fall ist bei Hinweisen auf eine bakterielle Labyrinthitis eine schnellstmögliche operative Fokussanierung notwendig, um eine Ertaubung und Weiterleitung der Infektion zu vermeiden. Gelingt es trotz Operation nicht, das Ohr vor der Ertaubung zu bewahren, sind MRT-Verlaufskontrollen notwendig, um die gefürchteten Ossifikationen der Cochlea, die bereits innerhalb von wenigen Wochen eintreten können, rechtzeitig zu erkennen. In diesen Fällen kann heute die Einlage einer Silikonsonde als Platzhalter für spätere Cochleaimplantatelektroden erfolgen oder direkt ein Cochlea-Implantat eingesetzt werden.

Die chronische Labyrinthitis führt schleichend zur Zerstörung des Innenohrs. Im Zusammenhang mit rezidivierenden bakteriellen Infektionen in der Pauke kommt es offenbar zur langfristigen Einwirkung von Toxinen über das runde Fenster und so zur Schädigung der Haarzellen mit langsam progredienter Innenohrschwerhörigkeit. Auch ein langsam progredienter Ausfall des Gleichgewichtsorgans ist möglich, wenngleich dieser Prozess in der Regel ohne Schwindel und Spontannystagmus verläuft. Chronische Labyrinthitiden können auch im Rahmen einer Bogengangsfistel bei freiliegendem Endolymphschlauch beobachtet werden.

Fazialisparese. Der N. facialis ist der Hirnnerv mit einem überdurchschnittlich langen knöchernen Kanal, der fast auf seiner gesamten Strecke an die Paukenhöhle und das Mastoid grenzt. Im Zusammenhang mit einem Cholesteatom im Kindesalter kann es im entzündeten Stadium auch zu einer Fazialisparese kommen, die weniger durch die Zerstörung des Knochenkanals (langsamer Prozess) als durch eine Überleitung der Entzündung im superinfizierten Stadium auf die Nervenscheide bedingt ist (Neuritis) mit den Folgen der Neurodyspraxie, Neurapraxie und im späteren Verlauf Axonetmesis. Bei akuten Fazialisparesen gilt es deshalb immer, eine Otitis media und ein Cholesteatom auszuschließen. Die Therapie der Wahl ist neben der Antibiose die rasche operative Sanierung ggf. mit Dekompression des Nervenkanals.

Sinusthrombose/Meningitis/Hirnabszess. Diese für die akute Otitis media typischen schweren Komplikationen sind bei Cholesteatomen im Kindesalter selten. Offenbar sind diese Verläufe an die langjährige Entstehung großer Raumforderungen gebunden. Bei Sinusthrombosen infolge eines Cholesteatoms unterscheidet man

•

eine akute infektiöse Thrombose,

•

eine Sinusthrombose durch mechanischen Druck des Cholesteatoms.

Während bei infektiöser Überleitung die Klinik dem typischen Verlauf einer lebensbedrohlichen Sepsis entspricht, kommt es bei der durch den mechanischen Druck bedingten Thrombose infolge des sukzessiven Knochenabbaus an der Sinusschale zu einer langsamen Kompression der Wand mit nahezu asymptomatischem Verlauf.

Jederzeit kann ein superinfiziertes Cholesteatom bei ungenügender Drainage und ungünstiger Abwehrlage auch zu einer Meningitis führen. Die Inzidenz ist jedoch deutlich niedriger als bei der akuten Otitis media. Hirnabszesse sind im Kindesalter infolge von Cholesteatomen ebenfalls nur in Ausnahmefällen nach langjährigem Verlauf zu beobachten. Dennoch sollte bei Hirnabszessen oder Meningitis eine hals-nasen-ohren-ärztliche Untersuchung erfolgen, um eine otogene Ursache auszuschließen.

Ménière’s Society: Labyrinthitis

Labyrinthitis is inflammation of the part of the inner ear called the labyrinth. The labyrinth is made up of fluid-filled channels which control balance and hearing. When the head moves, the fluid in the channels move and this tells the brain which direction a person is moving in and how far and fast they are going. This information helps the body to balance. Hearing is controlled by the part of the labyrinth known as the cochlea. When the organs of balance in an ear are inflamed the information sent to the brain will be different from the unaffected ear. This varied information can make a person feel dizzy. Hearing may also be affected if this part of the inner ear is also inflamed.

Who is affected by labyrinthitis?

Labyrinthitis can affect both men and women equally, at any age, although it is rare in children.

How is labyrinthitis diagnosed?

To reach a diagnosis a number of tests may be involved or the doctor may turn a patient’s head to see if this produces any dizziness. In some cases an MRI scan may be required. Usually only one ear is affected.

Viral labyrinthitis

In most cases, labyrinthitis is caused by a viral infection. Labyrinthitis often follows common illnesses such as a cold or flu. Viral labyrinthitis usually causes a sudden, violent onset of vertigo, nausea/vomiting as well as sudden hearing loss. As antibiotics are not effective against viruses, treatment is symptomatic and may include antivertiginous medications, antihistamines and bed rest. Within one week sufferers are usually able to sit up and after two weeks will begin to compensate for the dizziness/vertigo. Acute episodes usually end after one to two months. Although permanent vestibular damage may remain in some cases, most people recover fully from viral labyrinthitis. Vestibular rehabilitation exercises are sometimes recommended for patients after recovery, as these may help with any residual imbalance.

Bacterial labyrinthitis

With a chronic middle ear infection, bacteria may enter the inner ear through the oval or round windows, through the bone or as a result of injury to the head or ear. There may be sudden unilateral hearing loss along with nystagmus, vertigo and sickness. Treatment with antibiotics is usually successful in managing bacterial labyrinthitis and most recover fully. Care should be taken with driving, ladders or operating machinery for at least one week after the symptoms have gone as they may return.

Are there any long term effects?

For the majority, balance and hearing return to normal afterwards. Some people find they have mild dizziness when they move their head; this can happen for up to several years after they have had the infection. It is relatively uncommon for there to be complications from labyrinthitis, but they can include permanent hearing loss, tinnitus, or imbalance. This is more likely with bacterial than viral labyrinthitis. 

Read more about Labyrinthitis on the NHS Choices website

Watch the video ‘Labyrinthitis and Vertigo’ produced by NHS Choices

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Labyrinthitis – Symptoms, diagnosis and treatment

Labyrinthitis is an inflammatory condition affecting the labyrinth in the cochlea and vestibular system of the inner ear.

Viral infections are the most common cause of labyrinthitis. Bacterial labyrinthitis is a complication of otitis media or meningitis.

Typical presentation includes vertigo, imbalance, and hearing loss.

Diagnosis is supported by history, physical exam, and audiometry.

Treatment is typically symptomatic and primarily involves the use of vestibular suppressants and antiemetics.

Labyrinthitis is an inflammatory condition caused by bacteria or viruses that affects the inner ear, which consists of the cochlea and vestibular system. Typically, it presents with sensorineural hearing loss, vertigo, and disequilibrium (problems with balance) and may affect one or both ears. It may be further classified as suppurative or serous. Suppurative (bacterial) labyrinthitis follows direct microbial invasion of the inner ear and usually presents with severe to profound hearing loss and vertigo.[1]Lindeman RC. Acute labyrinthine disorders. Otolaryngol Clin North Am. 1979 May;12(2):375-87.
http://www.ncbi.nlm.nih.gov/pubmed/460880?tool=bestpractice.com
[2]Kangsanarak J, Fooanant S, Ruckphaopunt K, et al. Extracranial and intracranial complications of suppurative otitis media: report of 102 cases. J Laryngol Otol. 1993 Nov;107(11):999-1004.
http://www. ncbi.nlm.nih.gov/pubmed/8288994?tool=bestpractice.com
[3]Goldstein NA, Casselbrant ML, Bluestone CD, et al. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg. 1998 Nov;119(5):444-54.
http://www.ncbi.nlm.nih.gov/pubmed/9807067?tool=bestpractice.com
Serous (viral) labyrinthitis results from inflammation of the labyrinth only and usually presents with less severe hearing loss and vertigo than suppurative labyrinthitis, and the hearing loss often recovers.

Labyrinthitis and Vestibular Neuritis | Johns Hopkins Medicine

Labyrinthitis is an inflammatory or infectious condition that affects the labyrinth (the balance and hearing organs within the inner ear) and causes prolonged vertigo and hearing loss.

Vestibular neuritis is a condition that affects the vestibular nerve, which connects the inner ear to the brain, causing prolonged vertigo usually in the absence of significant hearing loss.

The onset of both conditions is typically abrupt over minutes to hours, and may involve vertigo, imbalance, jumping vision due to eye movements, nausea and vomiting.

Labyrinthitis and Vestibular Neuritis Symptoms

The following symptoms usually occur abruptly and persist for days or weeks.

• Severe, continuous vertigo (the sensation of spinning or tilting)

• Inability to balance or walk straight

• Nausea and vomiting, which can lead to dehydration and extreme fatigue

Diagnosis of Labyrinthitis and Vestibular Neuritis

Depending on the eye movement and vestibular examination, a test such as an MRI of the brain may or may not be necessary.

People experiencing these symptoms should see a doctor, especially since a stroke can have similar symptoms. Strokes are more common in people who have a history of smoking, high blood pressure, high cholesterol, diabetes, or previous stroke or heart attack.

With that in mind, call 911 immediately if symptoms are accompanied by:

• Double vision

• Slurred speech

• Weakness

• Numbness or tingling

Labyrinthitis and Vestibular Neuritis Treatment

With time and vestibular (balance) physical therapy, there is gradual improvement and the prognosis is generally good.

If the doctor believes the person’s condition is due to shingles, an anti-viral medication may be prescribed. Although prednisone or other types of steroids may be given and could help hasten recovery, it is not conclusively proved that these medications benefit in the final outcome.

Anti-nausea medications and medications used to treat the dizziness/vertigo should not be taken more than several days after symptom onset, since their use can delay normal compensation.

Labyrinthitis: Symptoms and Treatment | Directory of diseases Helzy

What is labyrinthitis

Labyrinthitis is an inflammatory disease of the inner ear (labyrinth), most often of an infectious nature. The labyrinth is the structure of the inner ear that is responsible for recognizing sound vibrations, transmitting information about them to the brain, and maintaining balance.

The disease is also known as

• Labyrinthitis;
• Vestibular neuritis;
• Vestibular neuronitis;
• Neurolabyrinthitis.

Causes

Labyrinthitis is always a consequence of another inflammatory process (due to the structure of the inner ear). The source of infection is usually located in the immediate vicinity of the labyrinth (middle ear and cranial cavity). The causative agent can be bacterial or viral in nature. The most common cause of the disease is otitis media – otitis media.

The development of labyrinthitis is also possible after trauma, craniocerebral or barotrauma of the ear.

Who is at risk

• Patients with acute and chronic otitis media;
• patients with meningitis;
• patients with ARVI, influenza, herpes virus infection, measles, rubella;
• patients with tuberculosis;
• patients with craniocerebral trauma;
• patients with barotrauma.

How common is it

Among ear diseases, labyrinthitis occurs in about 4% of patients.

Symptoms

Usually the disease manifests itself suddenly, it may be preceded by clinical manifestations of a viral or bacterial infection (fever, weakness, headache, sore throat, ears).

Characteristic symptoms:

• episodes of pronounced dizziness , which are often accompanied by nausea and vomiting;
• imbalance ;
• nystagmus – involuntary rapid movements of the eyeballs;
• hearing loss ;
• an increase in body temperature – especially characteristic of purulent labyrinthitis;
• bloating, noise and ear pain .

The duration of an attack can last from a few minutes to several days.

In severe labyrinthitis (purulent inflammation), hearing impairment up to complete deafness is possible.

Diagnosis of the disease

Interview and examination

The doctor collects in detail information about previous infections, head injuries, the presence of chronic otitis media or acute otitis media in the recent past.

The main complaint with labyrinthitis is a feeling of dizziness: any movement of the head can provoke an attack, so patients try to lie down and not move.

The doctor examines the external auditory canal, assesses the condition of the tympanic membrane, conducts tuning fork tests, audiometry (to determine the presence and type of hearing loss) and assessment of spontaneous vestibular nystagmus. Assessing static and dynamic balance (Romberg’s test and walking in a straight line) can reveal unsteadiness of gait, deviation of position to the side.

Laboratory examination

• Clinical blood test – often reveal an increase in the number of leukocytes with inflammatory changes in the leukocyte formula, increased ESR.
• Determination of C-reactive protein in the blood as a marker of inflammation – reveals its increase.

Functional, radial and instrumental diagnostics

• Radiography of the temporal bones – changes characteristic of the inflammatory process in the pyramid of the temporal bone are revealed.
• Computed tomography of the temporal bone allows you to more clearly determine the presence, severity and localization of the inflammatory process.
• MRI of the brain is performed if intracranial complications are suspected.Allows you to assess the spread of inflammation to the lining of the brain.

Treatment

Treatment goals

Relief of symptoms, elimination of infection and inflammatory changes in the structures of the labyrinth, prevention of complications.

Lifestyle and aids

Bed rest and plenty of drink are recommended. Treatment of the disease is carried out in an otorhinolaryngological hospital.

Medicines

With a mild course of the disease and the absence of a bacterial infection, treatment is carried out mainly in order to relieve symptoms: antiemetic, sedative, anti-inflammatory drugs are prescribed.

With the bacterial nature of the disease, treatment is carried out with antibacterial drugs of a wide spectrum of action.

There is no specific treatment for labyrinthitis associated with a viral infection. If necessary, antiemetic drugs, infusion therapy are also prescribed.

Surgical treatment

Surgical treatment is carried out in case of intracranial complications of the disease, as well as in the absence of improvement (with treatment started) within a week, a behind-the-ear antromastoidotomy is performed.

Possible complications

• Hearing loss, deafness;
• damage to the mastoid process;
• purulent intracranial complications.

Prevention

Prevention consists in the timely diagnosis of the disease. It is necessary to prevent a protracted course of inflammatory diseases of the middle ear, to timely prevent complications in traumatic brain injuries.

Forecast

The forecast depends on the type of labyrinthitis (the nature of the inflammation and the causes of the disease), the correct treatment.A complete recovery is possible, a decrease in auditory and vestibular functions or their complete loss.

What questions do you need to ask the doctor

• Is dispensary observation shown to me?
• How to prevent relapse?
• How to prevent the development of complications?

References

1. Labyrinthitis Treatment & Management.
2. Vestibular Neuritis and Labyrinthitis Infections of the Inner Ear. Charlotte L.Shupert, PhD with contributions from Bridget Kulick, PT and the Vestibular Disorders Association.
3. Clinical guidelines. Labyrinthitis, 2016

LABYRINTHITIS

Labyrinthitis is an inflammatory process of the internal
ear, which leads to impaired vestibular function. We briefly recall that
the labyrinth is a section of the inner ear, consisting of the organs used
to maintain balance. The labyrinth contains the ear nerve, and it is filled
liquid – endolymph.If you move the position of the head, the liquid inside
the labyrinth is set in motion, thereby stimulating the inner ear nerve.
It is obvious that the loss of the labyrinth function leads to imbalance, deterioration
hearing, the formation of constant tinnitus.

Reasons

Exact reason responsible for
the occurrence of labyrinthitis is not fully understood. However, it is assumed that
the disease is the result of a bacterial or viral infection.Provoke
labyrinthitis can be strokes, head injuries, severe allergic reactions to
drugs (especially antibiotics), extreme stress, severe cough.

After suffering from meningitis or
meningoencephalitis, purulent labyrinthitis may occur. In this case, the loss
hearing becomes irreversible and, unfortunately, almost always complete.

Symptoms

Labyrinthitis begins with symptoms like
as a rule, acute and severe, the leading of which is dizziness.A patient
complains about:

– confusion of consciousness;

– feeling of anxiety;

– difficulty maintaining balance;

– ringing in the ears;

– nausea;

– nystagmus;

– hearing loss;

– abdominal pain.

These symptoms are mainly due to sudden
the inability of the vestibular system to balance the body.

In most cases,
patients suffering from labyrinthitis are very scared of the condition that has arisen.Anxiety syndrome is very common in the context of labyrinthitis. Panic
attacks, depression, palpitations, and tremors can exacerbate the problem by prolonging
healing time.

Diagnostics

The patient is recommended to consult a specialist when
the earliest symptoms of the disease. There are a number of tests to determine the diagnosis,
the most common of which are the brainstem auditory response test, and electronystagmography.Diagnostic
the test is necessary for the analysis of vestibular disorder. Important information about
labyrinthitis can be represented by MRI – magnetic resonance imaging. This
a diagnostic test is used to reproduce images of the head
the brain, including the capillaries and structures of the head. As a result, you can find
brain damage associated with labyrinthitis.

Treatment

Treatment of labyrinthitis depends on the cause and severity of the condition.purpose
therapy – to reduce and prevent the symptoms accompanying the disorder. If a
the cause of labyrinthitis is a bacterial-viral infection come to the rescue
antibiotics and antiviral drugs (eg, acyclovir, valacyclovir).

Since the disease is accompanied by dizziness, often
nausea and vomiting, antiemetics can be of great help.
In addition, there are specific drugs to control vertigo.For
for this purpose, anticholinergic drugs are most commonly used. Sometimes for
to reduce inflammation, steroids are prescribed. Selective uptake inhibitors
serotonin helps to cope with feelings of anxiety and depression accompanying
labyrinthitis.

If you have any suspicions or questions about the condition
your health, you can seek advice and qualified
help to the specialists of the center
“Paracelsus”. We are always happy to help you.The reception is conducted by Kobys Petr Efimovich.

Labyrinthitis | LekOboz

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Vestibular neuronitis and labyrinthitis – Dizziness – Directory of nosologies – List of nosologies

Vestibular neuronitis, also known as labyrinthitis, is associated with a viral or post-infectious inflammatory lesion of the vestibular portion of the VIII pair of cranial nerves.

Vestibular neuronitis is characterized by a rapid onset with severe persistent dizziness, nausea, vomiting, and unsteadiness when walking. Objective examination data correspond to acute lesions of the peripheral parts of the vestibular analyzer: spontaneous vestibular nystagmus, a positive test of “impulse head rotation” (or “jerky head rotation”) and unsteadiness when walking without losing the ability to walk. With isolated vestibular neuronitis, hearing is not impaired; when combined with unilateral hearing loss, the syndrome is called labyrinthitis.

The diagnosis of vestibular neuronitis is usually based on clinical findings. The clinical picture of cerebellar hemorrhage or cerebellar infarction may be similar to vestibular neuronitis, therefore, neuroimaging is required to exclude these conditions.

Patients with vestibular neuronitis usually describe severe vestibular symptoms that persist for several days, followed by a decrease in the severity of symptoms, restoration of a sense of balance.Corticosteroid therapy can speed up patient recovery.

Ramsey-Hunt Syndrome

Development of Ramsey-Hunt syndrome (lesion of the geniculate node by the herpes zoster virus) with activation of latent herpes infection of the geniculate node.

In addition to acute dizziness and / or hearing loss, patients develop paresis of the mimic muscles on the affected side, ear pain, vesicular rashes in the area of ​​the auricle and external auditory canal.

Treatment with corticosteroids or acyclovir is possible, however, the effectiveness of these methods has not been proven (Sweeney C. J. Gilden D. H. 2001).

Meniere’s disease

Meniere’s disease is a peripheral vestibular disorder associated with increased endolymph pressure, which causes attacks of dysfunction of the inner ear structures.

Patients with Meniere’s disease have spontaneous attacks of dizziness that last from several minutes to several hours; usually accompanied by one-sided tinnitus, hearing loss, a feeling of fullness in the ear.Dizziness associated with Meniere’s disease is often severe and is combined with nausea and vomiting, functionally significant balance disorders. Balance disorders can persist for several days. On examination during an attack, horizontal torsion nystagmus is often detected.

The diagnosis of Meniere’s disease is established on the basis of anamnesis. The diagnosis is confirmed by hearing loss, mainly to low-frequency sounds, detected by audiometry and a unilateral decrease in the vestibular response with electronystagmography.

Exacerbations of Meniere’s disease can last for several months – several years, during which, the deterioration of the condition is noted for several days. The development of remission can be spontaneous or caused by treatment; after remission, relapses of the condition are possible.

Concussion of the labyrinth – traumatic damage to the peripheral parts of the vestibular analyzer due to direct traumatic effects on the brain. It also arises from sudden acceleration of the head, not necessarily associated with direct impact.More severe cases are associated with damage to the cochlear and / or vestibular structures in transverse fractures of the temporal bone pyramid. In these cases, simultaneously with dizziness, sensorineural hearing loss occurs and hematotympanum is noted.

Symptoms of dizziness, nausea and vomiting, balance disorders are most pronounced at the onset of the disease and decrease over the next days or months, depending on the severity of the injury.

Diuretics and Betahistine are moderately effective for the treatment of attacks of Meniere’s disease.The evidence for the effectiveness of the drugs is rather weak, studies indicate the safety of betahistine (Rosenbaum A. Winter M. 2017,2018).

The effectiveness of the introduction of corticotsteroids into the tympanic cavity has not been confirmed (Chuang-Chuang Á, Baeza M. A. 2017)

Perilymphatic fistula

An uncommon complication of traumatic brain injury, barotrauma or heavy lifting, during which a fistula develops in the auditory capsule, which allows changes in blood pressure to be transmitted to the receptors of the macula and cupula of the semicircular canal.This explains the development of dizziness and / or hearing loss when sneezing, lifting weights, straining, coughing or under the influence of loud noises. Finally, the so-called Tullio phenomenon develops due to the pressure caused by sound waves, which, due to pathological changes, can spread to the structures of the inner ear.

Diagnosis is difficult because clinical studies are not susceptible to this condition. Computed tomography (CT) scans can show fluid accumulation in the region of the cochlear window depression.Treatment is initially limited to bed rest, keeping the head elevated, excluding physical activity / straining; ineffectiveness of treatment within several weeks of conservative therapy is an indication for surgical closure of the defect. Relapses are observed in 10% of cases.

Dehiscence syndrome of the bone wall of the superior semicircular canal (DWPK)

The bone surrounding the upper sections of the superior semicircular canal becomes thinner or completely destroyed, which creates conditions for the propagation of pressure into the inner ear.Dizziness is triggered by coughing, sneezing, and the Valsalva maneuver. During short episodes of dizziness, patients may experience nausea and unsteadiness.

In this condition, loud sounds can cause dizziness (Tullio’s phenomenon), as the pressure caused by the sound waves propagates into the inner ear due to pathological changes. This phenomenon can be confirmed using the vestibulo-ocular reflex, in response to the sound of a click (cervical vestibular myogenic evoked potentials (VEMP)), which usually has a high amplitude and a low threshold in patients compared with the control group.Cochlear hypersensitivity is another diagnostic feature of this condition. In some patients, there is a decrease in hearing with a difference in sound conductivity between air and bone according to audiometry. One case report described rotatory pedunculated nystagmus that was synchronized with a palpable pulse and was suppressed by the Valsalva maneuver or the patient’s transition to a horizontal position.

Despite the fact that this condition is detected more often, it may remain unrecognized.Diagnosis can be made by evaluating the temporal bone on high-resolution CT. In some patients, improvement is possible due to surgical removal of the anatomical defect.

Vestibular paroxysm

A syndrome manifested by short-term attacks of dizziness, lasting from one to several seconds, which occur several times a day (Hüfner K, Barresi D, 2008). In some patients, seizures are spontaneous, in others, they are triggered by head movement or other types of activity.Common signs in the assessment are the development of nystagmus during hyperventilation, as well as mild vestibular disturbances during the caloric test, as well as signs of neurovascular conflict according to the MRI of the brain. The pathogenetic role of neurovascular conflict is ambiguous, and similar imaging results can be detected in asymptomatic patients. There is evidence that carbamazepine or oxcarbazepine reduce the severity and frequency of symptoms in at least some patients. Surgical decompression has been reported to be effective in patients who do not experience or tolerate conservative treatment.

Kogan’s syndrome

An autoimmune disease that leads to the development of interstitial keratitis and disorders in the cochleovestibular system.

Patients develop less-like seizures, including dizziness, ataxia, nausea, vomiting, tinnitus, and hearing impairment. Vestibular dysfunction can also cause oscillopsia, which is manifested by the sensation of objects moving back and forth after a sudden movement of the head from side to side.Caloric test often reveals the absence of vestibular disorders.

The condition may require treatment with systemic steroids or other immunosuppressants.

Recurrent vestibulopathy

Recurrent vestibulopathy is a descriptive diagnosis that is used for patients suffering from spontaneous episodes of vertigo unrelated to otological complaints (eg, hearing loss, tinnitus, tinnitus sensation) and migraine symptoms.Symptoms often include nausea, vomiting, and imbalance. Vertigo may occur infrequently, for example, every year – every two years. Vertigo regresses and the patient’s condition returns to normal without consequences.

The pathophysiology of recurrent vestibulopathy has not been established. The condition is considered as a consequence of vestibular disorders at an undefined level. Individual cases are of a family nature. This disorder may have aspects in common with vestibular migraines.

Vestibular schwannoma

Vestibular schwannoma (neuroma of the auditory nerve) – due to the slow growth of the tumor, small violations of the symmetry of vestibular afferentation are compensated by the central nervous system, and patients do not experience severe dizziness. The only signs of damage to the vestibular structures may be a sensation of movement or tilt of the head. A likely reason for a patient seeking medical attention may be unilateral hearing loss.

Toxic effect of aminoglycosides

Certain representatives of the aminoglycoside group, especially gentamicin, have a selective vestibulotoxic effect in approximately 10% of patients receiving intravenous drugs, causing peripheral damage to the vestibular structures without hearing impairment, mainly affecting the hair cells of the inner ear (Leis J. A. Rutka J. A. 2015).

Due to the symmetric lesion of the peripheral parts of the vestibular system, there is no imbalance in the vestibular impulses entering the central nervous system, and, therefore, the patient does not experience dizziness.Patients may have oscillopsia (an illusion of forward and backward movement of the environment) with head movement, indicating a violation of the vestibulo-ocular reflex. Bilateral damage to the structures of the vestibular analyzer is combined with deviations in the results of the “impulse head rotation” test in both horizontal directions, and also, with a decrease in visual acuity during shaking of the head, this can be recorded in caloric and rotary tests. Severe bilateral damage to the peripheral parts of the vestibular analyzer leads to chronic imbalance and oscillopsia.

A genetic predisposition to the development of the toxic effect of gentamicin associated with the carriage of individual variants of the mitochondrial gene MT-RNR1 (Dean L. 2018, Igumnova V. Veidemane L. 2019) was established.

Otitis media

Otitis media may be accompanied by vestibular disorders. Non-systemic dizziness develops more often than systemic dizziness, however, serous and purulent labyrinthitis can complicate the course of otitis media, causing severe dizziness.In patients with acute bilateral labyrinthitis, dizziness is often accompanied by fever, hearing loss, nausea, and vomiting. Patients require hospitalization and intravenous antibiotics.

If the impact on the wheels causes dizziness in a patient with otitis media, CT scanning of the temporal bone is indicated to exclude fistula of the bone labyrinth.

Development of mobile design for Labyrinth

One of the three largest bookstores in Russia

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Client

Labyrinth is one of the three largest bookstores in Russia and the top 25 online retailers on the Runet.

This is a full-scale online store with

hundreds thousand SKU

and different authorization methods, delivery options, a complex loyalty program, where points and discounts are layered on top of each other.

Book Labyrinth was founded in 1991, and came to mobile in 2015 – immediately to Surf. We liked our design the most and we looked the most interested in communication. Although the price was not lower than the rest.

Task

Mobile Design

for Labyrinth

We made our favorite bookstore mobile, first of all for ourselves.But since we started, we implemented Instant Apps, developed a visual search on a neural network and brought the application to the top in terms of reliability and functionality.

• Home was supposed to reflect all the variety of goods and define the style of the rest of the screens.
• Harmoniously placing 15 carousels of 3 types on the main one is half the success. And this is just the beginning.

Solution

Design

starts with main

Together with the Labyrinth, we brainstormed for a week how the product might look.The result of the transfer of knowledge about the service was two brief pages and layouts that clearly answered the question: how do you imagine the main page of a mobile application?

Having clarified the terms of reference, we began to draw a design that meets the visual preferences of the customer and the functionality he wants to get.

Labyrinth provided stylistic blueprints, and Surf developers delved into how it should look according to mobile standards.

The main thing that is agreed upon is how exactly this or that feature will look inside the application.

Start development: promising iOS

Having started making both platforms, we immediately realized that we were not in time, given the changes that had to be made.

This is now an Android smartphone capable of significantly competing with the iPhone, and in 2015, iOS users were the priority.

This was the case not only for the clients of the Labyrinth, but for mobile in general: Yabloko with expensive flagships were immediately recognized as a solvent audience, the rest used the phone rather for making calls.So we decided to focus on iOS.

In parallel with the design, we designed the API, optimized the work of the labirint.ru site and found several errors.

Design Informative Screens

Using the standard flow, a dynamic prototype is created with the functionality of the application so that you can test the usability: is the navigation clear, is the content readable, is such a screen informative.

The Labyrinth application turned out to be so large that everything froze – there were too many screens.To put it together, the designers tried three different prototyping services, stopping at InVision.

Let us recall that the start of the project (2015) fell on the era of the fifth iPhones and the fourth androids – the screen standard was then different from today, it was more difficult to make a convenient mobile design on a small field.

Version

for tablets

The scale of the project is also added by the fact that the version for iPads and android tablets is different, revised.

More tablet space allows you to fit everything on one screen without scrolling. Some screens even look different on a tablet and a phone.

Few applications allow themselves such a variety for devices (it is quite expensive), but the Labyrinth is important for users to be as convenient as possible.

Result

The first in Russia to implement

Instant Apps

2017 was a good year for both Surf and Labyrinth.Instant Apps is a Google technology that allows you to use a mobile application compressed to 4 MB without installing it on your phone.

In the search results, Instant Apps is displayed in a separate line, instantly downloaded to a smartphone and launched.

The user can take steps up to placing an order, and it is proposed to install the application already at the purchase stage.

Competently converting a native app into an Instant App is difficult: you need to take into account the main use cases, but do not forget about minimalism.Efficiency is increased by quality SEO settings.

At Google I / O 2017, among the first 50 applications in the world with Instant Apps, Labyrinth was the only one from Russia

Catching the wave is obliged by the position: Surf is among the 25 studios certified by Google. This opens the way for early access programs, we are the first to try new technologies even before they are released.

In 2017, contactless payment services became available to residents of Russia. Of course, we immediately presented Labyrinth users with the ability to add a bank card to the application to pay for purchases by introducing Android Pay and Apple Pay.

At Google’s Private Hackathon for Top Android Developers, Surf took first place for adding Android Pay to an app in just a couple of hours.

Discounts, bonuses and

custom content in the product card

Shares

For 5 years, the product card has been altered and refined several times. Now you can see a block of shares for a product in it, read an excerpt from a book – initially these functions were not there. The promotions in the card show the specific benefit for the selected book.

Cashback

It is impossible to foresee everything at the start: first, the Labyrinth itself, as a business, lived up to the introduction of the cashback system, then we reflected this in the card as well. The return of part of the money spent is another opportunity for the buyer to save money.

The main challenge for the project was the ever-growing content. For the labyrinth, with its audience of super loyal, but at the same time very demanding users, it was fundamentally important to get a cool product at the exit.And they wanted everything in the MVP.

However, to natively fit into a mobile application the logic that has been developed over the years is a certain level of quality that no one wanted to sacrifice.

In order for active users of the Labyrinth to see in the application all the functionality that they are accustomed to on the site, the customer’s backends made special methods for our development.

Visual search on neural networks

In 2018, the Labyrinth has a visual search.When you see an interesting book in an offline store or on a friend’s shelf, you can easily find it in the Labyrinth catalog. And find out the price with all the discounts. You just need to point the camera at the cover.

The work of visual search is based on a neural network. The ideal option is when it functions on the device itself.

Visual search is based on the SqueezeNet neural network, which we have adapted to work on mobile devices.

We do not stop at what has been achieved.Thousands of people use visual search today. This means that we have collected enough data to plan the next steps.

Project Development: Endless Labyrinth

A number of features that were discussed during the design phase were deferred for further application growth.

By defining what we are ready to sacrifice at the MVP stage, and what needs to be improved in the next version, a backlog was formed.

Complex loyalty program

Gift catalog.Users accumulate discounts that are superimposed on each other.

Quick search across multiple content types:

To authors, books, headings. Synchronization of the shopping cart in the application and on the site.

Huge catalog with multi-level nesting

Content caching and fast application performance.

And many other little things:

Authorization by 8 social networks, phone and other methods. 15 types of payment and 9 types of delivery.

Unimplemented features are ranked by priority.

The Labyrinth Collaboration Workflow is an annual session dedicated to the development and new features of the application.

Conduct cart UX research, apply Google’s Firebase churn prediction technology, and improve the recommendation system.

The application on both platforms is updated every 2-3 months, the expansion of functionality continues. Today, the mobile Labyrinth is ahead of the web version in development.

For example, only users of the mobile application can take part in the daily lottery “Lucky Roulette” from an online store.

Review

There are no random solutions on the bookstore’s website – each is tested in battle, their effectiveness has been proven. We just transferred them to the application. However, the opposite is now happening. When we finalize the site and want to get inspired, we peep into the application.

Boris Verks

design director and manager of Labyrinth

90,000 Vertigo treatment (DPPV)

About 75% of people with vertigo actually experience it due to a disease of the inner ear and vestibular apparatus – the so-called benign paroxysmal positional vertigo (BPPV).

Some people have constitutional inferiority of the vestibular apparatus, which in childhood is manifested by poor tolerance of swings, carousels, transport.

When visiting a doctor, patients with a complaint of dizziness are often given a preliminary diagnosis of vertebrobasilar insufficiency, which in many cases is associated with osteochondrosis of the cervical spine.

If the dizziness is so strong that the patient is sent to the hospital, then an acute disturbance of cerebral circulation is usually assumed, and with an increase in blood pressure – a hypertensive crisis.

However, these diagnoses are often not confirmed, and the cause of dizziness is the pathology of the vestibular apparatus – BPPV.

BPPV is a disease of the labyrinth of the inner ear, which is manifested by attacks of dizziness when changing the position of the head. Otolith particles, moving in the semicircular canals of the labyrinth, excite receptors, from which impulses go to the brain. Since there are no analogous changes in the opposite “healthy” labyrinth, the symmetry of impulses entering the brain is disturbed.This is manifested by dizziness.

The diagnosis of BPPV is based on: history, clinical presentation, examination, positional tests. In a patient with BPPV, no changes are found on MRI. BPPV is treated with special exercises and treatment maneuvers that the doctor will do at the reception. This is a safe technique, in 90% of cases the dizziness disappears immediately after the maneuver at the doctor’s appointment. After manipulation, short-term drug therapy and vestibular gymnastics are prescribed to accelerate vestibular rehabilitation and prevent recurrent dizziness.In some cases, you have to repeat the maneuver after 7 days.

A timely visit to a doctor will help to correctly diagnose and carry out treatment, and when a diagnosis of BPPV is established, a cure is possible after a single maneuver in the doctor’s office.

Physician neurologist, MC “Capital-Policy” Matveeva Larisa Vladimirovna

90,000 symptoms and causes. Labyrinthitis treatment.

Labyrinthitis is an inflammation of the inner ear, namely an inflammation of the labyrinth.The labyrinth is located deep in the inner ear and consists of 3 semicircular canals, which are responsible for balance control.

Labyrinthitis symptoms

The main symptoms of labyrinthitis are severe dizziness with every movement of the head and hearing loss. Vertigo may develop gradually and reaches a maximum after 48 hours.
Other symptoms: spontaneous nystagmus, that is, involuntary convulsive movements of the eyeballs, nausea, vomiting, and hearing loss.

Causes of labyrinthitis

Tibetan medicine associates diseases of the inner ear with disturbances in the “penetrating wind” system, which is responsible for the state of the organs of the head.

Most often, labyrinthitis is triggered by an upper respiratory tract infection (ARVI, influenza). Less commonly, a middle ear infection. Even less often, labyrinthitis is caused by a bacterial infection.

Treatment of labyrinthitis

Treatment of labyrinthitis is considered a serious problem in modern medicine.
Clinical experience shows that the effectiveness of treatment increases significantly when non-drug methods are included in the complex of treatment, which can play a decisive role in recovery or achieving long-term remission of the disease.

In our clinic, the treatment of diseases of the inner ear is carried out using a complex of procedures of Tibetan medicine – massage of the head and cervicobrachial region, acupuncture and microzonal massage of the auricles, acupuncture, therapeutic applications and the appointment of phytopreparations that improve blood supply and innervation of the inner ear structures.

Complex therapy has a significant anti-inflammatory effect, helps to restore microcirculation of the inner ear and reduce intra-labyrinth pressure.Thanks to this, it is possible to significantly reduce the painful symptoms of the disease and slow the development of hearing loss. The use of the methods of Tibetan medicine can be the key to success in the fight against diseases of the inner ear.

or call:

+7 495 781-57-57 (Moscow)
+7 812 643-20-70 (St. Petersburg)

Free consultation

Interrogation, inspection,

pulse diagnostics

from 30 minutes

Diagnostics

Ultrasound, MRI, laboratory

research (by appointment)

Treatment

Individual

plan

Diagnostics of the labyrinthitis

Patients are accepted for treatment in a compensated state, who have undergone examination: MRI of the brain, MRI of the cervical spine, ultrasound Doppler of the vessels of the neck and head and a complete examination in otorhinolaryngological clinics.