Labyrinthitis

What is labyrinthitis?

Labyrinthitis (la-br-uhn-THAI-tuhs) is a type of inner ear infection. It happens when your labyrinth gets inflamed. Your labyrinth is the part of your inner ear responsible for your hearing and sense of balance.

Labyrinthitis is closely related to vestibular neuritis. Labyrinthitis is the swelling of both branches of your vestibulocochlear nerve. It affects both balance and hearing. Vestibular neuritis is the swelling of one branch of your vestibulocochlear nerve. It affects only balance.

Anyone can get labyrinthitis. But it’s most common in adults ages 30 to 60. People assigned female at birth (AFAB) are twice as likely to develop labyrinthitis as people assigned male at birth (AMAB).

What are the symptoms of labyrinthitis?

People with labyrinthitis may experience a sudden onset of symptoms, including:

• Balance issues.
• Blurred vision.
• Difficulty concentrating.
• Dizziness.
• Hearing loss.
• Nausea and vomiting.
• Nystagmus (involuntary eye movements).
• Ringing in your ears (tinnitus).
• Vertigo.

What causes labyrinthitis?

Viral infections cause labyrinthitis in most cases. But bacterial infections can cause it, too. Some of the most common labyrinthitis causes include:

• Epstein-Barr virus.
• Herpes simplex.
• Stomach flu.
• Upper respiratory infections.

Less commonly, a head injury can result in labyrinthitis.

Risk factors

Having a cold or flu can trigger labyrinthitis. You also have a higher risk of developing labyrinthitis if you smoke or if you have:

• Alcohol use disorder.
• Allergies.
• Fatigue.
• Stress.

Certain drugs — like antidepressants, anti-inflammatories and some diabetes medications — can also trigger labyrinthitis in some people.

Complications of labyrinthitis

Labyrinthitis is usually not dangerous unless it goes untreated. Without appropriate care, labyrinthitis can lead to hearing loss, increased risk of falling and permanent damage to your inner ear.

Permanent hearing loss is a common side effect in children who develop labyrinthitis as a complication of meningitis. In cases like this, you may be able to restore hearing with a cochlear implant.

How is labyrinthitis diagnosed?

Your healthcare provider will perform a physical examination and ask you about your symptoms and medical history. They may also order tests to assess your hearing, balance and other nervous system functions.

What tests will be done to diagnose labyrinthitis?

There are other conditions that have the same symptoms as labyrinthitis (like vestibular neuritis or BPPV), so your healthcare provider will need to rule them out. They may do this by running certain tests, including:

• Electrocardiogram (EKG).
• Magnetic resonance imaging (MRI).
• Vestibular testing.

How is labyrinthitis treated?

Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery.

Medications

Common labyrinthitis medications include:

• Antivirals (if a virus caused it).
• Antibiotics (if a bacterium caused it).
• Corticosteroids to reduce nerve inflammation.
• Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine).

Physical therapy

If your symptoms don’t improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance.

Home remedies

You can also try home remedies to ease labyrinthitis symptoms:

• Apply a warm compress over your ear.
• Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear).
• Limit alcohol intake.
• Try stress management techniques, like mindfulness or meditation.

During a flare-up, avoid sudden movement. It’s best to lie still and keep motion and bright lights to a minimum.

Surgery

Very rarely, you might need a labyrinthectomy. During this procedure, a surgeon removes your vestibular end organs (the thin, membrane-like parts of your inner ear).

Providers don’t recommend labyrinthitis surgery very often. It’s a last resort treatment for people with vertigo and significant hearing loss in the affected ear.

Can labyrinthitis be prevented?

Because labyrinthitis is usually a symptom of other conditions, the best way to avoid it is to wash your hands regularly and take proper precautions during cold and flu season.

How long does labyrinthitis last?

Labyrinthitis symptoms and their response to treatment can vary for everyone. What works well for one person may not work as well for you. Recovering from labyrinthitis can take up to six weeks. But many people feel better after a week or two.

If you’re experiencing vertigo or balance issues, ask your healthcare provider when it’s safe to go back to work or school.

When should I see my healthcare provider?

If you develop vertigo, nausea or balance issues, you should call your healthcare provider right away. They can help determine the cause of your symptoms and design a personalized treatment plan.

What questions should I ask my healthcare provider?

If you have labyrinthitis, here are some questions you might want to ask your healthcare provider:

• How can I stop my symptoms?
• What tests do I need?
• What medications can I take?
• Will I have hearing loss?
• What are my treatment options?

What’s the difference between vertigo and labyrinthitis?

Labyrinthitis is inflammation of your inner ear labyrinth. Vertigo, a common symptom of labyrinthitis, can make you feel like your surroundings are spinning.

What’s the difference between labyrinthitis, vestibular neuritis and Ménière’s disease?

These conditions all affect parts of your inner ear. But there are key differences:

A note from Cleveland Clinic

Labyrinthitis usually isn’t serious. But it can cause debilitating side effects. The resulting vertigo can make it hard for you to get out of bed and go about your daily life. Should you develop symptoms, don’t wait until they get worse. Timely treatment can reduce the likelihood of long-term inner ear issues.