Fact-sheet: Labyrinthitis
Updated on 04/24/2020 at 9:48 AM
View all RADEOS cases associated with this fact-sheet
Definition
Inflammation of variable etiology involving the membranous labyrinth.
It is most often viral in origin (herpes, haemophilus influenzae, rubella) but may also be bacterial.
Bacterial labyrinthitis is the form with the poorest prognosis.
It occurs by extension from acute otitis media (through an acquired fistula, for example caused by a cholesteatoma, or of congenital origin) or from purulent meningitis
Autoimmune labyrinthitis follows a different clinical course.
Serous labyrinthitis: a less severe bacterial form occurring during acute otitis media, for example, due to diffusion of bacterial toxins into the labyrinth
Clinical features
Vertigo similar to that of vestibular neuritis but always associated with hearing loss
CT
Useful in the late stages of bacterial labyrinthitis, when inflammatory or fibrous tissue may calcify or ossify (stage of ossifying labyrinthitis)
MRI
Viral labyrinthitis:
- In the acute phase: mild intralabyrinthine enhancement that does not persist long
- T2 hyperintensity (absence of fibrosis or inflammatory tissue)
Bacterial labyrinthitis:
- Intense enhancement of the membranous labyrinth persisting for a long time (several months or even more than a year)
- T2 hypointensity (inflammatory tissue and fibrosis)
Management
Symptomatic treatment (antiemetics, antivertiginous agents)
Rest
If bacterial involvement: antibiotic therapy