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Margaret asked...

I think I have labyrinthitis

I think I have labyrinthitis, and am due to fly overseas in the next few days. What are the symptoms of labyrinthitis and will I be able to fly with it? I am not currently taking any medication.

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The answer

Labyrinthitis is the medical name for inflammation of the ‘labyrinth’ in your inner ear, commonly caused by a viral infection. Viral labyrinthitis often comes on quickly in otherwise healthy people, and symptoms may start after a simple cold.

What are the symptoms of labyrinthitis?

Symptoms of labyrinthitis can include:

  • Dizziness- feeling as if surroundings are spinning
  • Nausea
  • Ear pain-ringing or humming in ears (tinnitus)
  • Hearing loss
  • Loss of balance
  • Mild headaches

Many people refer to vertigo when they feel lightheaded or off balance. In medical terms, vertigo is different from other forms of dizziness because the dizziness has to be accompanied by a sensation that the room is spinning round. It can often be associated with feeling or sometimes being sick.

Diagnosis is usually made on the basis of your symptoms but can also be made by means of physical examination and tests such as blood tests, MRI and CT scans or Lumbar puncture.

What are the causes of labyrinthitis?

Labyrinthitis can be either viral or bacterial. Viral infection usually stems from the chest, nose, mouth or airways, usually from a cold or flu. This is the most common form of labyrinthitis - it is usually mild, gets better on its own after a few weeks and does not cause any permanent damage.

With bacterial infection, bacteria enter the inner ear from the middle ear when the membrane separating them is broken, perhaps as a result of an ear infection or sometimes a brain infection (meningitis). With this form of the condition, symptoms tend to go on for longer and long term ear damage is more common.

What is the treatment for labyrinthitis?

In most cases, the symptoms of labyrinthitis pass within a few weeks. Management of the condition involves a combination of bed rest and medication to help you cope better with the symptoms. In some cases you may need additional medication to fight the underlying infection:

Self-help

  • Drink plenty of water in early stages when the dizziness and vertigo is usually at its worst
  • Bed rest
  • Avoid alcohol and smoking
  • Avoid bright lights and noise.

Medication

  • Benzodiazepines (which slow down the central nervous system)
  • Anti-emetic (anti-sickness)
  • Corticosteroids (to reduce inflammation)
  • Antibiotics (if the cause is bacterial).

Vestibular rehabilitation therapy for persistent labyrinthitis

A small number of people have persistent symptoms that last for several months, or even years. In these cases a more intensive type of treatment, called vestibular rehabilitation therapy (VRT) may be used. Usually carried out by a physiotherapist, VRT attempts to "retrain" the brain to cope with the altered signals that come from the vestibular system of the inner ear.

You will need to speak with your Doctor about the treatment they feel is appropriate for you.

Can you fly with labyrinthitis?

Some people do find it makes their symptoms worse, however it shouldn’t do serious damage.

Here are a few tips which may help:

  • Decongestants and nasal sprays
  • Air pressure regulating ear plugs may help during take-off and landing
  • Use techniques such as yawning and swallowing when you notice a change in air pressure
  • Do not travel in unpressurised aircraft.

Not to be mistaken for…

Symptoms of labyrinthitis are similar to those of Menière’s disease, which causes intermittent episodes of vertigo, fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in one or both ears. Diagnosis is suspected by the history but warrants a more detailed examination by an ENT doctor along with a hearing test and MRI scan (to exclude other causes).

Answered by the Health at Hand nurses  

Sources and further reading

Labyrinthitis - NHS Factsheet

Vertigo - NHS Factsheet

Dizziness - NHS Factsheet

Menière’s disease - NHS Factsheet

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