Introduction
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. It is an inflammatory response within the membranous inner ear structures in response to infection. It is a generally short-lived minor illness that has the potential to cause temporary or permanent disablement in terms of hearing loss. Other symptoms include nausea and vomiting, pain in the affected ear, vertigo, and fever. Subsequently, it is an illness commonly diagnosed by health care practitioners working in the community setting. Understanding the pathophysiological development and the inflammatory and immune response to such an illness enables the clinician to comprehend the underlying processes of the presenting signs and symptoms, and to treat accordingly.
Signs & symptoms
- dizziness
- vertigo, which gives a person the sensation of spinning or the world spinning around them
- tinnitus or ringing in the ears
- nausea
- loss of balance
- hearing or vision problems
- 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 for labyrinthitis include:
- smoking
- heavy alcohol consumption
- a history of allergies
Pathophysiology
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 semi-circular 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.
Diagnosis
There are no specific tests to diagnose labyrinthitis. After a thorough physical examination and neurological evaluation doctor will rule out any other conditions, such as:
- Meniere’s disease
- vestibular neuritis
- head injury
- brain tumour
- stroke
- cardiovascular disease
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.
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Aim of the treatment is to relieve symptoms.
Antihistamines to ease some of the symptoms of viral labyrinthitis, such as nausea or dizziness.
Corticosteroids or sedatives for people with more severe symptoms.
Antibiotics in cases of bacterial infection.
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.
Prognosis
In mild cases, typically it resolves on its own within a few weeks. In moderate and severe cases, proper medications can reduce symptoms and aid recovery. But untreated labyrinthitis can lead to serious long-term health complications, such as permanent damage to the inner ear and hearing loss.
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.
Complications
Permanent damage to the inner ear.
Hearing loss.
Benign paroxysmal positional vertigo (BPPV)
Disease & Ayurveda
Poothikarna
Nidana
Injury to head
Dipping the head in unclean water
Purvaaroopa
Not mentioned
Samprapti
The kapha in the srotas of the ear gets melt(Kaphavilayana)and inflamed(Vidagdha) by the heat of Pitta and causes ghana(thick),pooti(purulent), inflammation in the ear with or without pain.
Lakshana
Ghana (thick), and pooti (purulent) inflammation in the ear with or without pain.
Divisions
Not mentioned
Prognosis
Sadhya
Chikithsa
Samana
Karnapoorana with nirgundiswarasatailam
Sodhana
Nasyam with Priyanguadi tailam
Commonly used medicines
Anutailam
Brands available
AVS Kottakal
AVP Coimbatore
Home remedies
- warm compresses on the affected ear,
- saltwater gargle, not smoking,
- over-the-counter (OTC) pain killers.
Diet
- To be avoided
A person with disease in ear should be very selective about his food.
He should not eat,
Dry and hard food items which cause biting hard to break.
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digeastion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni(digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric.
Protein-rich and less fat food items like pulses, soya bean, meat etc according to digestion.
Warm fresh milk and pure ghee.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Avoid head bath.
Avoid any activities involving movement of head including vigorous brushing of teeth and combing of hair.
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Do not sleep during day time.
Yoga
Exercises and Yoga.
Any kind of head movement and physical exercises are not advised in most of the cases of labyrinthitis. If the doctor allows, relaxing exercises and specific yoga asanas like Hastapadasana, Setubandhasana etc are recommended.
Hastapadasana
Setubandhasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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