---
title: "Labyrinthitis"
description: "ENT notes on Labyrinthitis - Types, Causes, Pathology, Clinical Features, Investigations and Treatment."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/labyrinthitis-symptoms-treatment"
categories: ["Otology"]
video: "https://www.youtube.com/watch?v=bSoMl7iLVi8"
image: "https://media.theentresident.com/og-images/labyrinthitis-symptoms-treatment.png"
---

# Labyrinthitis

ENT notes on Labyrinthitis - Types, Causes, Pathology, Clinical Features, Investigations and Treatment. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=bSoMl7iLVi8

## 🦻 Labyrinthitis 

Labyrinthitis is an **inflammatory condition of the inner ear** that often arises as a complication of **CSOM (Chronic Suppurative Otitis Media)** or **AOM (Acute Otitis Media)**.  

It can be classified into three types:

1. **Circumscribed Labyrinthitis** (Labyrinthine fistula)
2. **Diffuse Serous Labyrinthitis**  
3. **Diffuse Suppurative (Purulent) Labyrinthitis**

In this post, we focus on **Diffuse Serous** and **Diffuse Suppurative** labyrinthitis.

---

### 🔍 Diffuse Serous Labyrinthitis

### 📖 Definition of Diffuse Serous Labyrinthitis

A **diffuse intralabyrinthine inflammation** without pus formation.  

- **Reversible** if diagnosed and treated early  

---

### 📌 Causes of Diffuse Serous Labyrinthitis

- **Most common:** Pre-existing **labyrinthine fistula** (CSOM or cholesteatoma)  

- Acute otitis media or mastoiditis (bacterial/viral toxins invading via oval/round window)  

- Meningeal inflammation 

- Ear surgeries 

---

### 🩺 Clinical Features of Diffuse Serous Labyrinthitis

- **Spontaneous vertigo** in a patient with middle ear infection → strong suspicion  

- Associated **nausea & vomiting**  

- Irritative type nystagmus  

- Positive **fistula test** (if due to labyrinthine fistula)  

- Mild, reversible **sensorineural hearing loss**  

- Caloric test: diminished vestibular response  

>What is Irritative type of nystagmus?

>What is fistula test? What does Positive Fistula test mean?

>What will happen if Diffuse Serous Labyrinthitis is left untreated?

---

### 💊 Treatment of Diffuse Serous Labyrinthitis

**Goals:** Prevent progression to suppurative stage & avoid meningitis  

- **Bed rest** with head immobilized (affected ear up)  

- **IV antibiotics** – control middle ear & labyrinth infection  

- **Labyrinthine sedatives** for vertigo relief  

- Myringotomy ± grommet insertion  

- **Surgical options**:  
  - Cortical mastoidectomy (acute mastoiditis)  
  - Modified radical mastoidectomy (cholesteatoma)  

>What are some labyrinthine sedatives used in Diffuse Serous Labyrinthitis?

---

### 🧬 Diffuse Suppurative (Purulent) Labyrinthitis

### 📖 Definition of Diffuse Suppurative Labyrinthitis

A **diffuse pyogenic infection** of the labyrinth → **permanent loss** of vestibular & cochlear function.  

- **Irreversible** condition

---

### 📌 Causes of Diffuse Suppurative Labyrinthitis

- Often follows **serous labyrinthitis** when pyogenic organisms enter via:
  - Pathological/surgical fistula (CSOM, cholesteatoma, AOM, meningitis)

>What are the Predisposing factors of Diffuse Suppurative Labyrinthitis?

---

### 🦠 Routes of Infection of Diffuse Suppurative Labyrinthitis

1. Tympanogenic

2. Meningogenic – Meningitis  

3. Hematogenic – Systemic infection, meningitis, encephalitis, brain abscess  

>What is the most common route of infection of Diffuse Suppurative Labyrinthitis?

---

### 🩺 Clinical Features of Diffuse Suppurative Labyrinthitis

1️⃣ **Acute Stage (1–2 weeks)**

- Rapid onset
- Severe, persistent symptoms (8–12 hrs) not responding to treatment initially  
- Head movement triggers severe vertigo  
- **Irritative nystagmus** → later becomes **paralytic nystagmus**  
- Severe SNHL, past pointing, tendency to fall towards diseased side  
- Unilateral 

2️⃣ **Chronic (Latent/Fibrous) Stage (1–6 weeks)**

- Milder vestibular upset, positional vertigo  
- Absence of cochlear & vestibular functions  
- Bilateral cases → difficulty walking in dark/soft surfaces  

3️⃣ **Healed (Compensated/Ossification) Stage**
- Labyrinthitis ossificans 

>What is Labyrinthitis ossificans?

---

### 💊 Treatment of Diffuse Suppurative Labyrinthitis

- Same principles as **serous labyrinthitis**  
- Rarely, **labyrinth drainage** if it acts as a source of intracranial complication

---

## About This Note

This free ENT note on Labyrinthitis was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/labyrinthitis-symptoms-treatment

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Otology: https://www.theentresident.com/ent-notes-lectures/category/otology.md

## About The ENT Resident

The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

## Medical-use Boundary

The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

## More Resources

- Learn about the Premium ENT Notes, preview a complete sample, and find purchase options: https://www.theentresident.com/premium.md
- Premium note for this topic, Labyrinthitis: https://theentresident.gumroad.com/l/dshpi
- Read student testimonials: https://www.theentresident.com/testimonials.md
- Contact The ENT Resident: https://www.theentresident.com/contact.md

---

A complete index of all pages on this site, with descriptions and markdown links can be found here: https://www.theentresident.com/llms.txt