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Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
Labyrinthitis
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Labyrinthitis

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Labyrinthitis

Labyrinthitis

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  • 1. LABYRINTHITIS
  • 2. Labyrinthitis Inflammation of the labyrinth of the inner ear. 2
  • 3. Etiology • • • • • • Viral or bacterial infections Cholesteatoma Drug toxicity Head injury Tumour Vasculitis
  • 4. Clinical manifestations • Vestibular manifestations (vertigo) • Cochlear manifestations (hearing loss) • Nausea and vomiting 4
  • 5. Pathology • Infection usually occurs by one of three routes: – From the meninges – From the middle ear space – Hematogenous spread 5
  • 6. Pathology • Meningogenic: through the IAC, cochlear aqueduct, both (bilateral) • Tympanogenic: extension of infection from the middle ear, mastoid cells or petrous apex-most common through the round or oval window (unilateral) • Hematogenous: through blood, least common 6
  • 7. Bacterial Infections Two types of labyrinthitis associated with bacterial infections: Toxic Labyrinthitis Suppurative Labyrinthitis 7
  • 8. Toxic Labyrinthitis • Toxic Labyrinthitis: results from a sterile inflammation of the inner ear following an acute or chronic otitis media or early bacteria meningitis. • Toxins penetrate the round window, IAC, or cochlear aqueduct and cause an inflammatory reaction in the perilymph space. 8
  • 9. Bacterial Infection Toxic Labyrinthitis produces mild high frequency hearing loss or mild vestibular dysfunction Treatment: Antibiotics for precipitating otitis, possible myringotomy. 9
  • 10. Suppurative Labyrinthitis • Suppurative Labyrinthitis: direct invasion of the inner ear by bacteria. • From otitis or meningitis 10
  • 11. Suppurative Labyrinthitis: 4 stages 1. Serous or irritative: production of Ig rich exudates in the perilymph 2. Acute or purulent: bacterial and leukocyte invasion of the perilymphatic scala-end organ necrosis 3. Fibrous or latent: proliferation of fibroblasts and granulation tissue in the perilymph 4. Osseous or sclerotic: new bone deposition throughout the involved labyrinth 11
  • 12. Diagnosis • History: – severe vertigo from any movement of the head. – Nausea and vomiting – U/L or B/L hearing loss – Recent URTI – Loss of balance and falling in the direction of the affected ear. 12
  • 13. Diagnosis • Physical findings: – Spontaneous nystagmus – Jerking movements of eyes toward unaffected ear – Purulent discharge • Lab: – Culture and sensitivity test • Audiometry • A flat tympanogram • Electronystagmography
  • 14. Management • • • • • Meclizine to relieve vertigo Antiemetics Antibiotics Oral fluids IV fluids for severe dehydration
  • 15. Surgery • Surgical excision of cholesteatoma • Incision and drainage • Labyrinthectomy
  • 16. Complications • Meningitis • Permanent balance disability • Permanent hearing loss
  • 17. Thank you

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