Purulent labyrinthitis is a bacterial infection of the inner ear that often causes deafness and loss of balance.
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).
Purulent labyrinthitis usually occurs when bacteria enter the inner ear during a severe infection of the middle ear (acute otitis media), during some forms of meningitis, or after a fracture of the temporal bone 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 (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
Tinnitus (noise or ringing in the ear)
Varying degrees of hearing loss
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 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 to see if the infection extends into the brain.
If people have symptoms of meningitis, such as confusion, stiff neck, or high fever, doctors do a lumbar puncture (spinal tap) and send samples of spinal fluid to the laboratory for culturing.
Treatment of Purulent Labyrinthitis
Intravenous antibiotics
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). Sometimes tympanostomy 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).
