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Labyrinthitis

Labyrinthitis is a diffuse or limited lesion of the peripheral parts of the sound and vestibular analyzers. It occurs with acute or more often chronic inflammation of the middle ear (cholesteatoma), tuberculosis of the middle ear, trauma. Depending on the path of development, inflammatory diseases of the inner ear can be divided into tympanogenic, meningogenic and hematogenous. There are also purulent and non-purulent lesions of the maze, and diffusion and limited in distribution.

Symptoms, the course depend on the localization of the process in the inner ear. In the initial stages of the disease, the labyrinth is irritated (tinnitus, dizziness, nausea, hearing loss, spontaneous nystagmus, imbalance, vomiting). Spontaneous nystagmus is directed to the sick side; if there is oppression of the maze - to the healthy side. The intensity of the dizziness is very different. The equilibrium disorder is observed at rest and during movement. With serous labyrinthitis, pathological changes are the formation of exudate and edema in all the soft parts of the labyrinth. With a favorable course of the disease, a gradual resorption of exudate occurs. Limited labyrinthitis occurs with or without fistula. The fistula is more often located on the horizontal channel. With purulent labyrinthitis, temperature may increase. With diffuse purulent labyrinthitis, complete hearing loss occurs.

Diagnosis is difficult if the labyrinthitis is accompanied by complications such as cerebellar abscess, meningitis. The partial preservation of the function of the cochlear and vestibular apparatus indicates a limited or serous labyrinthitis. Complete loss of their functions indicates diffuse purulent labyrinthitis.

Treatment. With serous and limited labyrinthitis with residues of the functions of the labyrinth, conservative treatment is indicated (bed rest, dehydration and antibacterial therapy). With labyrinthitis with a fistulous symptom and preserved maze function, if antibiotic therapy is ineffective, general cavity trepanation is indicated. The absolute indication for surgery on the labyrinth at the same time as surgery on the middle ear is sequestration of the labyrinth or purulent labyrinthitis with labyrinthogenic intracranial complications.