Formula Medical Group
Apple Valley, CA

James Krider, MD

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Inner-ear infection - Labyrinthitis

Structures of the inner ear are instrumental both in hearing and in maintaining balance.


Structures of the inner ear are instrumental both in hearing and in maintaining balance.

What is an inner-ear infection?

This is an infection of the ear's labyrinth, a group of fluid-filled chambers that control balance. (Thus, the medical name for the condition is labyrinthitis.)

When the labyrinth becomes infected and inflamed, its function is totally disrupted, resulting in severe dizziness or vertigo. True vertigo is an illusion of motion. A person with vertigo feels


  • Severe vertigo.
  • Inability to maintain proper balance.
  • Nausea and vomiting.
  • Temporary loss of hearing in one ear.

constantly off balance, as if he or she (or the room) is spinning around. This sensation can lead to nausea and vomiting. In addition, the eyes may move improperly, drifting slowly sideways and then flicking back to their original position.

What causes an inner-ear infection?

The problem may be caused by either bacterial or viral infection. When it is due to bacteria, it usually develops as a secondary effect of an acute middle-ear infection (otitis media) or bacterial meningitis; in other cases it may be secondary to tuberculosis or syphilis.

Viral inner ear infections may arise independently or be secondary to upper respiratory infections, such as colds or flu. In such cases, the inner-ear infection usually develops on the second or third day of the cold.

How is an inner-ear infection diagnosed and treated?

A precise description of the nature of the dizziness is an important diagnostic clue for the physician. True vertigo involves

a spinning sensation and always points to a problem in the ear's vestibular system. The problem may originate in the inner ear, in the nerve connecting the inner ear to the brain, or in the brain itself.

In contrast, other forms of dizziness — such as feeling faint or lightheaded — point to problems elsewhere in the body and help to rule out a diagnosis of an inner-ear infection.

The doctor also asks about the onset of the vertigo, any other symptoms, and any recent illnesses. A complete physical examination, including close examination of the ears, is performed. In some cases, blood tests and other studies may also be recommended. Dizziness can be caused by a variety of problems, ranging from motion sickness to brain tumors and heart, neurologic, and psychiatric diseases, many of which must be ruled out.

What can I do myself?
Because even slight head movement can worsen the vertigo, stay in bed and remain as quiet as possible.

Dim lights may also help ease queasiness.

When should I see my doctor?
Any unexplained dizziness should prompt a call to a physician. People with labyrinthitis, however, usually do not need to be urged to call the doctor. The vertigo of an inner-ear infection is so marked and debilitating that it usually makes people seek medical help promptly. Severe vertigo may make it impossible to travel. In such a situation, the doctor may be able to make a home visit.

What will the doctor do?
Initially, the physician is likely to prescribe a tranquilizer and antinausea medication. Such symptomatic treatment is usually all that is necessary for a viral inner-ear infection. If

bacterial infection is suspected, antibiotics will be prescribed. If the inner-ear infection is severe (particularly if meningitis occurs), hospitalization for intravenous antibiotic therapy may be necessary. In addition, severe cases may warrant surgery — specifically a labyrintliectomy, an operation to drain the inner ear.

The course of an inner-ear infection

The course of an inner-ear infection depends on the cause of the inflammation. Viral labyrinthitis usually does not have long-term serious consequences, although it is temporarily debilitating. The infection tends to be self-limiting, and usually disappears within 1 to 3 weeks.

Severe inner-ear infections caused by bacteria are often referred to as purulent or suppurative labyrinthitis. In bacterial labyrinthitis, complete hearing loss usually occurs in the affected ear. When the inflammation is secondary to chronic otitis media, facial paralysis also may occur.

In addition, there is a danger that purulent labyrinthitis can lead to meningitis, because the bacteria gain access to the central nervous system or the brain through the cochlea in the ear.

Is an inner-ear infection dangerous?
Normally, no. But untreated bacterial labyrinthitis can lead to serious problems, including meningitis.

What can I do to avoid an inner-ear infection?

  • Seek prompt treatment for any middle-ear infection.
  • During a cold or respiratory infection, avoid forceful noseblowing, since it can push infectious material into structures of the middle and inner ear.
This article was last reviewed December 1, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Infection, bacterial
Infection, viral
Otitis media

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