Labyrinthitis (inflammation of the inner ear)

Inflammation of the inner ear normally is a serious complication of purulent otitis media. Occurs as a result of infection in the inner ear. The way of infection transmission is different. She gets there from chronic middle ear (rarely acute) it inflammation (tympanogenic labyrinthitis), sometimes on the part of the meninges at epidemic (cerebrospinal) meningitis, tuberculosis and much less at cold in the chest, scarlatina, measles and typhus meningitis (Minerageny labyrinthitis). When labyrinthitis occurs when any infection (mumps), without signs of infection of the meninges, say haematogenic labyrinthitis.
There are the following main forms of labyrinthitis: limited labyrinthitis, acute diffuse serous labyrinthitis, acute diffuse purulent labyrinthitis, chronic diffuse purulent labyrinthitis. Also described, and the fourth form of labyrinthitis - as necrotic labyrinthitis. This form was observed in the old days, when skarlatines and tuberculosis, measles rarely otitis media, chronic cholesteatomic otitis, and after abseolutley operations on the ear in the presence of the fistula semicircular canal (limited labyrinthitis). In this form of labyrinthitis formation occurs sequesters (sequestered all the snail or one or two semicircular canal, or almost all labyrinth array).
The symptomology of labyrinthitis. Acute labyrinthitis start so-called labyrinth attack: the reduction or complete disappearance of hearing, sudden dizziness, disturbance of the balance accompanied by nausea and vomiting. Is characterized by the appearance of the labyrinth spontaneous nystagmus.
Limited labyrinthitis occurs mainly with chronic purulent otitis media, complicated caries and cholesteatoma. Recognition of this form of labyrinthitis helps history with characteristic labyrinth attack, the so-called fistulous (pistolero) symptom and preserved, albeit reduced, the hearing. Pistolry symptom is called by pressing your finger on the trestle or compression in the ear canal by means of balloon Politzer. When the concentration of air in the ear canal patient ear appears eye towards the same ear, in the rarefaction of the air movement is directed in the opposite direction, i.e. towards a healthy ear. Labyrinth attack is worsening limited labyrinthitis and transition in acute serous. Only under this condition requires emergency care. Acute diffuse serous labyrinthitis can be observed in acute otitis media, but in some cases with chronic suppurative otitis media. In this form of labyrinthitis ear drops very low and decreases anxiety maze. Spontaneous nystagmus is directed first towards the patient's ear and then goes to the healthy side. Labyrinth symptoms (reduction in hearing, dizziness, nausea, vomiting, loss of balance, and others) is usually pronounced. The patient is forced to lie on the side of healthy ear, slightly bowed to the front of the head. By changing the position of the head dizziness increases and is accompanied by vomiting.
Acute diffuse purulent labyrinthitis is the most serious and dangerous form of the disease. Beginning of the disease violent and causes very fast loss of function of the maze; often it is preceded by the acute serous labyrinthitis. Typical signs of the disease in the first hours are marked noise in the ear, spontaneous nystagmus in the direction of a patient ear, and in the following you receive the full deafness on the patient side and spontaneous nystagmus already in the healthy side. Labyrinth attack, usually accompanied by the subjective feeling dizziness, loss of balance, and the patient is for this reason has to be lying down. The disease does not always end in a complete loss of hearing and vestibular functions on the patient ear.
Diffuse purulent labyrinthitis is observed as in acute otitis media and chronic suppurative otitis media, especially epitympanitis, accompanied cholesteatoma. To identify deafness on a sore ear, before the hearing study a speech to stifle healthy ear (ratchet baranyi and others). Even a minor safety of hearing indicates the absence of purulent process in the maze. The emergence of high temperature, headache, meningeal symptoms that are not typical of purulent the labyrinthitis, is a signal coming intracranial complications.
Minerageny labyrinthitis is often purulent; occasionally serous and usually affects both ears. In most cases, a persistent complete deafness and loss of excitability of the maze. Usually strikes young children. Such children become blind, deaf and dumb, for hearing loss does not allow them to possess it.
Emergency care. In acute labirintit should ensure the patient is at rest, strict bed rest, antibiotics. Immediately show the patient ENT doctor. If there are any symptoms of acute labyrinthitis always shows urgent hospitalization in ENT hospital. Long distances such patient's best to transport by air, as less traumatic.
When serous labyrinthitis shown in bed, hospitalization, subcutaneous administration of 0.2 - 0.5 ml of 1 % solution of hydrochloric acid pilocarpina, the ingestion of tablets Aeron (1 tablet 3 times a day), intravenous infusion 5-10 ml of 40% solution urotropine and antibiotic treatment. Acute effect in the labyrinth attack has a mixture Korneeva: Amynasini 2,5% - 1,0; Dimedroli 2,5% -1,0; Ephedrini of 0.25% and 0.5 - intramuscularly.
In some cases there may be a case of surgical intervention in the form unloading operations (for example, antrotomii, ear radical surgery) or opening of the maze (what should remember the physicians providing emergency care).