The diagnosis of labyrinthitis is made by an ENT doctor (ENT doctor). In some cases, for the correct diagnosis, they resort to a consultation of a neurologist and an infectious disease specialist. Labyrinthitis is characterized by the presence of such complaints as:
- dizziness;
- impaired coordination of movements;
- hearing impairment;
- a buzz in one or two 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, an ENT doctor can use a number of different instrumental diagnostic methods. In more detail the consequences, course, general characteristics and clinic of the labyrinthitis are below. You will also learn about the consequences of the disease.
Causes of Labyrinthitis
Labyrinthitis is an otolaryngic disease that develops as a result of infection by the pathogens in the anatomical cavity of the inner ear. Modern medicine distinguishes the following factors contributing to the development of this pathology:
- Chronic inflammatory processes localized in various parts of the ear. Otitis is one of the main causes of the development of labyrinthitis. The accumulation of purulent masses increases the pressure on the eardrum, as a result of which it is damaged, this contributes to the penetration of pathogens into the internal cavity.
- Postponed 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 is significantly increased. This phenomenon can be observed when complications occur during meningitis or due to the untimely provision of medical care.
- Injuries. Ear injuries are most common in children, damage to the structural membranes of the inner ear occurs due to various mechanical damage (child cleansing of the ear without parental control, injury by sharp foreign objects, injuries during the fall).
- Complication after a viral illness.
Symptoms of labyrinthitis
Manifestations of the pathology are very spontaneous and acute. The clinical manifestations of the disease are characterized by the presence of such symptoms:
- Painful sensations.
- The presence of purulent discharge.
- The development of vestibular disorders.
- The appearance of impaired coordination of movements is manifested systematically, the patient has a persistent loss of balance when changing postures.
- The appearance of signs of intoxication. 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 eardrum, resulting in temporary hearing loss.
- Noise in ears.
- The emergence of autonomic disorders.
- Nystagmus. It is one of the first signs of inflammation in the inner ear cavity. Eye movements are of an involuntary nature and become more frequent with complications of the disease.
- Exacerbation of the symptoms of the disease increases with an attempt to turn the 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 state of health.
Diagnostics
The following methods for the diagnosis of labyrinthitis are distinguished:
- Otoscopy is used to examine the auricle, the ear region of the external auditory meatus (together with the mastoid process) and the tympanic membrane. In addition, the doctor certainly probes all 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. Analysis of these methods is based on 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 of 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 for conducting audiometry you need a specialized soundproof room.
- Electronistagmography is considered a way that allows you to quantitatively and high quality to assess the nystagmus that appears with labyrinthitis. This method is based on recording the difference in electric potentials between the cornea of the eye and the retina. Acquired information is recorded on magnetic tape and subsequently processed by a computer, which makes it possible to establish a variety of characteristics of nystagmus. The result of electron-histagometry makes it possible to distinguish nystagmus, due to pathology of the vestibular apparatus, from other types of nystagmus.
Effects
Labyrinthitis is an inflammation that develops in the inner ear. The disease disrupts the activity of the vestibular receptors and hearing organs. With untimely and improper treatment, labyrinthitis can cause quite serious health consequences. The inflammatory process from the inner part of the ear can quickly switch to neighboring organs of the ear, which threatens with possible complications of purulent labyrinthitis:
- Mastoiditis, in which the temporal bone is infected.
- Sensorineural hearing loss is a non-infectious disease that is accompanied by impaired hearing function.
- Petrozite - the inflammatory process affects the pyramid of the temporal bone.
- Encephalitis and meningitis are the most dangerous conditions in which the lining of the brain is affected.
- A brain abscess is a complication of labyrinthitis, which is difficult to cure, and if not detected promptly, it often leads to the death of the patient.
The highest risk of complications of labyrinthitis lies in wait for children who have a weak immune system. In order to prevent an unpleasant outcome of this disease, you need to consult a doctor as soon as possible, at the first signs of an ailment. Proper treatment and diagnosis are the components of a complete recovery without consequences! Labyrinthitis is a dangerous disease, and you can not leave it 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 a meal, dispensed according to the prescription of the attending physician. The antibiotic is consumed for seven days. The drug can cause allergic reactions, so it should be taken with caution. It is available in suspensions, tablets and capsules, so it can be easily taken by patients of any age. The drug is prohibited for 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 quick action, the patient will feel better after a couple of hours. It is not recommended to take during pregnancy and renal failure. It is allowed to apply to children who have reached the age of four. It is not recommended to be taken with other drugs because of the possible appearance of a skin rash. An antibiotic can cause allergic reactions, diarrhea, headaches and anaphylactic shock.
"Ciprofloxacin"
Another universal antibiotic is Ciprofloxacin from the fluoroquinol group. It is popular among specialist doctors. It is forbidden to take pregnant women and children. The drug is characterized by a quick effect. The medication causes insomnia, overwork, diarrhea, hives, nausea, dizziness and tachycardia.
Netilmicin
Another antibacterial drug is Netilmicin from the aminoglycoside group. It is applied through local ear injections. Treatment is prescribed by the attending physician, and it varies from one to two weeks. May cause an allergy. The drug should not be taken by pregnant women, the elderly and during the lactation period.
It has a huge list of side effects, among which are disorders of the central nervous system, digestive organs, kidneys, liver and cardiovascular system.
These drugs fight infection, relieve inflammation, reduce intoxication, relieve vomiting, nausea, dizziness, and improve blood flow. Medicines are prescribed by a doctor. Do not self-medicate with labyrinthitis, because if you do not know the characteristics of individual drugs, you can cause serious harm to the body.
Dehydration therapy
It is aimed at reducing edema and reducing pressure inside the maze. For this purpose, diuretics, glucocorticosteroids, hypertonic solutions (glucose, magnesium sulfate, calcium chloride) are prescribed. It is also required to follow a diet with a restriction of salt and liquid.
Surgery
An indication for surgery with labyrinthitis is a number of different pathologies and complications:
- Irreversible hearing loss occurs with acute or chronic injury. Deafness can also occur with a fracture of the temporal bone due to damage to the structures of the labyrinth and the auditory nerve. In this case, an auditory repair procedure can help patients regain hearing.
- Purulent labyrinthitis leads to the absolute defeat of the organ of Corti. 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.
- The 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 bone segments of the temporal bone. Mastoiditis or petrozitis, as a rule, can be cured by the surgical method (procedure to remove purulent sources).
- The penetration of the virus from the cavity of the inner ear into the brain. One of the complications of labyrinthitis is the spread of the inflammatory process along the auditory nerve into the brain. In this case, meningitis, meningoencephalitis (inflammation of the substance of the brain and membranes) or an abscess of the brain (accumulation of pus) may appear.
Operation Techniques
Today, there are a huge number of different techniques and options for surgical opening of the cavity of the inner ear. In any case, the doctor (otosurgeon) selects a more optimal technique.
To access the maze, you can use the appropriate techniques:
- Ginsberg's way.
- Neumann's way.
At the beginning of the procedure, regardless of the method used, a general-cavity (advanced) 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, with a labyrinthitis, the wound is usually plugged loosely and left open.
Ginsberg method
The labyrinth is opened in the area of the cochlea and the vestibule from the edge of the lateral (horizontal) semicircular canal. An autopsy is done with a special surgical bit in the area, which corresponds to the main coil of the cochlea. Surgical manipulations should be clearly carried out, since if the bit under the blow of the hammer jumps to the oval window, this will lead to a defect of 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 performed. Then, through this path, a special spoon is used to cure the vestibule and the passages of the cochlea.
Neumann Way
This method is considered the most constructive, since not one, but simultaneously 2 semicircular canals (external and lateral) are revealed. After these channels have been opened, the snail is scraped. This method is much more difficult than the Ginsberg method, however, it makes it possible to better perform the drainage of the labyrinth (outflow of pathological secretion from the cavity of the inner ear).