The labyrinth is the bony cavity that contains the inner ear. The inner ear contains the organs of hearing (the cochlea) and of balance (see also Overview of the Inner Ear Overview of the Inner Ear The fluid-filled inner ear (labyrinth) is a complex structure consisting of two major parts: The organ of hearing (cochlea) The organ of balance (vestibular system) The cochlea and the vestibular... read more ).
Purulent labyrinthitis usually occurs when bacteria enter the inner ear during a severe infection of the middle ear (acute otitis media Otitis Media (Acute) Acute otitis media is a bacterial or viral infection of the middle ear. Acute otitis media often occurs in people with a cold or allergies. The infected ear is painful. Doctors examine the eardrum... read more ), during some forms of meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be... read more , or after a fracture of the temporal bone Temporal Bone Fracture The temporal bone (the skull bone containing part of the ear canal, the middle ear, and the inner ear) can be fractured, usually by a blow to the head. A temporal bone fracture may cause facial... read more of the skull. It may also occur when people have a chronically perforated eardrum (as may occur in people who have repeated episodes of otitis media), particularly when people have a cholesteatoma (a collection of skinlike material) that grows in the perforated eardrum. Cholesteatomas are not cancerous, but they can destroy bone.
Symptoms of Purulent Labyrinthitis
Symptoms of purulent labyrinthitis include
Severe vertigo Dizziness and Vertigo Dizziness is an inexact term people often use to describe various related sensations, including Faintness (feeling about to pass out) Light-headedness Dysequilibrium (feeling off balance or... read more (a false sensation of moving or spinning) and nystagmus (a rapid jerking movement of the eyes in one direction alternating with a slower drift back to the original position)
Nausea and vomiting
Varying degrees of hearing loss Hearing Loss and Deafness
People also commonly have pain and fever.
Diagnosis of Purulent Labyrinthitis
Computed tomography (CT) and/or magnetic resonance imaging (MRI)
Sometimes a spinal tap
Doctors suspect purulent labyrinthitis if people have vertigo, nystagmus, hearing loss, or a combination during an episode of acute otitis media. Chronic infection of the middle ear or a cholesteatoma increases the risk of purulent labyrinthitis.
Doctors do a CT scan Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more of the skull to look for abnormalities in the temporal bone, which contains the inner and middle ear and the bone behind the ear. Doctors may also do an MRI Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more to see if the infection extends into the brain.
If people have symptoms of meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be... read more , such as confusion, stiff neck, or high fever, doctors do a lumbar puncture Spinal Tap Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more (spinal tap) and send samples of spinal fluid to the laboratory for culturing Culture of Microorganisms Infectious diseases are caused by microorganisms, such as bacteria, viruses, fungi, and parasites. Doctors suspect an infection based on the person's symptoms, physical examination results,... read more .
Treatment of Purulent Labyrinthitis
Drainage of fluid from the middle ear
Purulent labyrinthitis is treated with antibiotics given by vein (intravenously). Doctors also do a myringotomy. In this procedure, an opening is made through the eardrum to allow fluid to drain from the middle ear (see Myringotomy: Treating Recurring Ear Infections Myringotomy: Treating Recurring Ear Infections ). Sometimes tympanostomy Treatment Acute otitis media is a bacterial or viral infection of the middle ear. Acute otitis media often occurs in people with a cold or allergies. The infected ear is painful. Doctors examine the eardrum... read more is done. For this procedure, tubes are placed through a cut made in the eardrum so that fluid can drain out of the middle ear. Some people may need a more extensive surgical procedure to remove all or part of the bone behind the ear (mastoidectomy).