Labyrinthitis: Difference between revisions

| name = Labyrinthitis and vestibular neuritis

| frequency = 35 million per year<ref name=Gre2014/>{{dubious|date=November 2023|1=Epidemiology}}

'''Labyrinthitis''' is inflammation of the labyrinth, alsoa knownmaze asof fluid-filled channels in the inner ear. '''vestibularVestibular neuritis''', is inflammation of the vestibular nerve (the nerve in the inner ear that sends messages related to motion and position to the brain).<ref>{{cite web | url=https://www.nhs.uk/conditions/labyrinthitis/ | title=Labyrinthitis and vestibular neuritis | date=23 October 2017 }}</ref><ref>{{cite book| title= Ferri's Clinical Advisor 2016: 5 Books in 1|date= 2015| publisher= Elsevier Health Sciences| isbn= 9780323378222 |page= 735| url= https://books.google.com/books?id=bbLSCQAAQBAJ&pg=PA735}}</ref><ref name=Hog2015>{{cite journal |last1= Hogue| first1= JD| title= Office Evaluation of Dizziness. |journal= Primary Care| date=June 2015| volume= 42| issue=2|pages=249–258| pmid= 25979586| doi= 10.1016/j.pop.2015.01.004}}</ref> isBoth theconditions involve [[inflammation]] of the [[inner ear]].<ref>{{cite web| title= Labyrinthitis|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0027300/|website= [[National Library of Medicine]] | access-date=16 March 2018|language=en}}</ref> Vestibular neuritis derives its name from the [[Bony labyrinth|labyrinthsLabyrinths]] that house the [[vestibular system]], which sensessense changes in the head's position or the head's motion.<ref name=":1">{{Cite journal |date=1990-10-01|title=Clinical Methods: The History, Physical, and Laboratory Examinations| journal= Annals of Internal Medicine| volume=113|issue=7|pages=563|doi=10.7326/0003-4819-113-7-563_2|issn=0003-4819}}</ref> ThisInflammation of these inner ear parts results in a [[vertigo|]] (sensation of the world spinning]]) and also possible [[hearing loss]] or [[tinnitus|]] (ringing in the ears]]).<ref name=":1" /> It can occur as a single attack, a series of attacks, or a persistent condition that diminishes over three to six weeks. It may be associated with [[nausea]], [[vomiting]], and eye [[pathologic nystagmus|nystagmus]].

The cause is often not clear. It may be due to a [[virus]], but it can also arise from [[bacteria]]l infection, [[head injury]], extreme [[stress (biological)|stress]], an [[allergy]], or as a reaction to [[medication]]. 30% of affected people had a common cold prior to developing the disease.<ref name=Gre2014>{{cite journal|last1=Greco|first1=A|last2=Macri|first2=GF|last3=Gallo|first3=A|last4=Fusconi|first4=M|last5=De Virgilio|first5=A|last6=Pagliuca|first6=G|last7=Marinelli|first7=C|last8=de Vincentiis|first8=M|title=Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?|journal=Journal of Immunology Research|date=2014|volume=2014|pages=459048|pmid=24741601|doi=10.1155/2014/459048|pmc=3987789|doi-access=free}}</ref> Either bacterial or viral labyrinthitis can cause a permanent hearing loss in rare cases.<ref>{{cite web|title=NLM|url=https://www.nlm.nih.gov/medlineplus/ency/article/001054.htm}}</ref> This appears to result from an imbalance of neuronal input between the left and right inner ears.<ref name="Marill">{{cite web |last=Marill |first=Keith |title=Vestibular Neuronitis: Pathology |url=http://emedicine.medscape.com/article/794489-overview#showall |publisher=eMedicine, Medscape Reference |access-date=2011-08-07 |date=2011-01-13}}</ref>

The main symptoms of labyrinthitis are severe [[vertigo (medical)|vertigo]] and [[Pathologic nystagmus|nystagmus]]. The most common symptom for vestibular neuritis is the onset of vertigo that has formed from an ongoing infection or trauma.<ref>{{Citation|last1=Dewyer|first1=Nicholas A.|title=Inner Ear Infections (Labyrinthitis)|date=2018|work=Infections of the Ears, Nose, Throat, and Sinuses|pages=79–88|publisher=Springer International Publishing|isbn=978-3-319-74834-4|last2=Kiringoda|first2=Ruwan|last3=McKenna|first3=Michael J.|doi=10.1007/978-3-319-74835-1_7}}</ref> The dizziness sensation that is associated with vertigo is thought to be from the inner ear labyrinth.<ref>{{Citation|last1=Murdin|first1=Louisa|chapter=Betahistine for symptoms of vertigo|date=2013-08-11|pages=CD010696|editor-last=The Cochrane Collaboration|publisher=John Wiley & Sons, Ltd|language=en|doi=10.1002/14651858.cd010696|last2=Hussain|first2=Kiran|last3=Schilder|first3=Anne GM|title=Cochrane Database of Systematic Reviews|doi-access=free}}</ref> Rapid and undesired eye motion ([[pathologic nystagmus|nystagmus]]) often results from the improper indication of rotational motion. Nausea, anxiety, and a general ill feeling are common due to the distorted balance signals that the brain receives from the inner ear system.<ref>{{Cite journal|title=Table 1: The Single Nucleotide Polymorphisms in cathepsin B protein mined from literature (PMID: 16492714). |journal=PeerJ BIOINFORMATICS AND GENOMICS|doi = 10.7717/peerj.7425/table-1|doi-access=free}}</ref> Other common symptoms include [[tinnitus]], ear ache, and a feeling of fullness in the ear.<ref>{{Cite web|title=Infections of the Inner Ear|url=https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/|url-status=live|website=Vestibular Disorders Association}}</ref><ref>{{Cite web|title=Inner Ear Infection (Labyrinthitis) Symptoms, Causes, Contagious, Treatment Cure|url=https://www.medicinenet.com/labyrinthitis_inner_ear_inflammation/article.htm|access-date=2021-02-28|website=MedicineNet|language=en}}</ref>

This can also be brought on by pressure changes such as those experienced while [[Aviation|flying]] or [[scuba diving]].<ref name="pmid2317181">{{cite journal |vauthors=Martin-Saint-Laurent A, Lavernhe J, Casano G, Simkoff A |title=Clinical aspects of inflight incapacitations in commercial aviation |journal=Aviation, Space, and Environmental Medicine |volume=61 |issue=3 |pages=256–60 |date=March 1990 |pmid=2317181 }}</ref><ref name=farmer>{{cite conference |editor=Farmer, Jr JC |title=Labyrinthine Dysfunction During Diving |conference=1st [[Undersea and Hyperbaric Medical Society]] Workshop. |volume=UHMS Publication Number WS6-15-74. |publisher=Undersea and Hyperbaric Medical Society |year=1973 |pages=11 |url=http://archive.rubicon-foundation.org/4291 |archive-url=https://web.archive.org/web/20081007191953/http://archive.rubicon-foundation.org/4291 |url-status=usurped |archive-date=October 7, 2008 |access-date=2009-03-11}}</ref><ref name="pmid4619861">{{cite journal |author=Kennedy RS |title=General history of vestibular disorders in diving |journal=Undersea Biomedical Research |volume=1 |issue=1 |pages=73–81 |date=March 1974 |pmid=4619861 |url=http://archive.rubicon-foundation.org/2663 |archive-url=https://web.archive.org/web/20090703175002/http://archive.rubicon-foundation.org/2663 |url-status=usurped |archive-date=July 3, 2009 |access-date=2009-03-11}}</ref>

In the vestibular system, there are three [[Semicircular canals|canals]] that are semicircular in shape that input sensory clues.<ref>{{Cite web|url=http://www.audiologicaldiagnostics.com/labyrinthitis|title=Labyrinthitis|website=www.audiologicaldiagnostics.com|access-date=2019-12-02|archive-date=2019-11-23|archive-url=https://web.archive.org/web/20191123203817/http://www.audiologicaldiagnostics.com/labyrinthitis|url-status=dead}}</ref> These canals allow the [[brain]] to sense rotational motion and linear motion changes.<ref name=":2">{{Cite journal|date=2017|title=Germany|journal=International Journal of Health Care Quality Assurance|volume=19|issue=4|doi=10.1108/ijhcqa.2006.06219dab.003|issn=0952-6862}}</ref> The brain then uses the sensory input clues and the visual input clues from the vestibular system to retain balance. The [[vestibulo–ocular reflex]] retains continuous visual focus during motion which is also the vestibular systems job during activity.<ref name=":2" />

Recovery from a temporarytemporarily damaged inner ear typically follows two phases:

Labyrinthitis affects approximately 35 million people per year{{dubious|date=November 2023|1=Epidemiology}} (approximately 3.5 cases per 100,000 people).<ref name="Gre201422">{{Cite journal|last1=Greco|first1=A.|last2=Macri|first2=G. F.|last3=Gallo|first3=A.|last4=Fusconi|first4=M.|last5=De Virgilio|first5=A.|last6=Pagliuca|first6=G.|last7=Marinelli|first7=C.|last8=de Vincentiis|first8=M.|date=2014|title=Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?|journal=Journal of Immunology Research|volume=2014|pages=459048|doi=10.1155/2014/459048|issn=2314-7156|pmc=3987789|pmid=24741601|doi-access=free}}</ref> It typically occurs in those between 30 and 60 years of age,<ref name="Gre201422" /> and there are no significant differences between male and female incidence rates.<ref name="Gre201422" /> In 95% of cases, sufferers experience a single attack and fully recover.<ref>{{Cite web|url=https://my.clevelandclinic.org/health/diseases/15227-vestibular-neuritis|title=Vestibular Neuritis|website=Cleveland Clinic|language=en|access-date=2019-11-15}}</ref> Vestibular rehabilitation showed a statistically significant increase in controlling symptoms over no intervention in people who have vestibular neuritis.<ref>{{Cite journal|last1=McDonnell|first1=Michelle N|last2=Hillier|first2=Susan L|date=2015-01-13|editor-last=Cochrane ENT Group|title=Vestibular rehabilitation for unilateral peripheral vestibular dysfunction|journal=Cochrane Database of Systematic Reviews|volume=1|pages=CD005397|language=en|doi=10.1002/14651858.CD005397.pub4|pmid=25581507|doi-access=free}}</ref>