Labyrinthitis

Labyrinthitis is an infection of the inner ear. It makes the labyrinth inside your ear swell and become inflamed, and that affects both your hearing and your balance.

It usually comes on suddenly, and that can be frightening. You should see a doctor straight away.

The labyrinth is the innermost part of the ear. It has 2 parts:

• the cochlea, which sends sounds to the brain so you can hear
• the vestibular system, a complex set of fluid-filled tubes that affect your balance

The labyrinth usually becomes inflamed because of one of two things:

• a viral infection, such as a cold or flu (viral labyrinthitis)
• a bacterial infection, which is much less common (bacterial labyrinthitis)

The most common symptoms of labyrinthitis are:

• vertigo (dizziness), which is the sensation that you, or the environment around you, is moving
• hearing loss, from mild to total loss of hearing
• a feeling of pressure inside your ear(s)
• ringing or humming in your ear(s) (tinnitus)
• feeling sick (nausea) or being sick
• mild headaches

Certain things can make the dizziness worse, including:

• colds or illness, or anything that makes you feel generally unwell
• the dark
• tiredness or jetlag
• being on your period

Avoid driving, using tools and machinery, or working at heights if you're feeling dizzy.

• you have symptoms of labyrinthitis
• your symptoms are getting worse

Your doctor may:

• ask about your symptoms
• check your medical history
• carry out a physical examination (you may be asked to move your head or body, and the doctor can check your ears for signs of inflammation and infection)
• test your hearing, because labyrinthitis is more likely if you have hearing loss
• check your eyes, because if they're flickering uncontrollably your balancing system may not be working properly

By the time labyrinthitis is causing you trouble, you'll usually have seen a doctor already, and you may have started some treatment. There are also things you can do at home during this time to help manage your symptoms.

• drink plenty of water so you don't become dehydrated (it's best to drink little and often)
• lie still in a dark room if you feel very dizzy
• lie in a comfortable position (on your side is often best)
• try to get enough sleep, because tiredness can make symptoms worse
• try to cut down noise and anything around you that causes stress
• avoid alcohol
• avoid bright lights

If your symptoms are particularly severe, your doctor may prescribe:

• prochlorperazine, which can help with dizziness and sickness
• antiemetic, which can help if you're feeling sick and vomiting
• corticosteroids, which can help by reducing inflammation

A small number of people have dizziness and vertigo for months or years. This is known as chronic labyrinthitis.

Chronic labyrinthitis needs a treatment called vestibular rehabilitation therapy (VRT). A physiotherapist usually supervises it. You can ask your doctor to refer you, or you can pay for private treatment. If you go to a private physiotherapist, make sure they are fully qualified and a member of a recognised body, for example the Chartered Society of Physiotherapy (CSP). Not all physiotherapists have training in VRT, so tell them you need this type of treatment before you make an appointment.

Most cases of viral labyrinthitis happen in adults aged 30 to 60 years old, and it's quite common in this age group. Other types of ear infection are usually more common in children.

Bacterial labyrinthitis is much less common. Younger children under 2 years old are more vulnerable to it.

Many people diagnosed with labyrinthitis have only the balance symptoms, without any hearing loss.

Strictly, this is known as vestibular neuronitis rather than labyrinthitis.

But both names are often used for the same diagnosis.