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Highlights & Basics
- Labyrinthitis and vestibular neuritis are distinct conditions of the ear with similar presentations. While labyrinthitis involves inflammation of the inner ear, vestibular neuritis involves inflammation of the vestibular nerve. The cause of this inflammation can be infectious, inflammatory, or otherwise idiopathic.
- Viral infections are the most common cause, but labyrinthitis can also be caused by advanced bacterial infections of the middle ear (complicated acute otitis media).
- Patients with either condition have vertigo, nausea and vomiting of variable duration, and/or disequilibrium. Vestibular neuritis is not associated with hearing loss, whereas labyrinthitis may lead to hearing loss and/or tinnitus due to inflammation of the cochlea and cochlear nerve.
- Diagnosis is supported by history, physical exam, audiometry, and vestibular tests. Imaging can help rule out important alternative differential diagnoses.
- Treatment is typically symptomatic and primarily involves the use of systemic corticosteroids, vestibular suppressants, antiemetics, and long-term vestibular rehabilitation. In patients with labyrinthitis, antivirals or antibiotics may be needed to address the underlying viral or bacterial infections. Corticosteroids may be administered systemically or locally with intratympanic injection, based on the timing of presentation and patient's medical status, in a paradigm that mirrors the management of idiopathic sudden sensorineural hearing loss.
Quick Reference
History & Exam
Key Factors
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Diagnostics Tests
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Definition
Epidemiology
Etiology
Pathophysiology
Citations
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