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Pathology of Labyrinthitis

Dr Sampurna Roy MD 

 

                                                                                                                      

 

 

Labyrinthitis is an inflammation of a structure in your inner ear called the labyrinth. 

Labyrinth is located inside the inner ear, deep in the bone at the base of the skull.

It is made up of 3 semicircular canals that help in control of  hearing and balance.

The labyrinth consists of inter-connected channels filled with fluid and these channels are at different angles.

When the head moves, the rolling of the fluid tells the brain how far, how fast and in what direction the head is moving.

This information allows the body to balance properly. Part of the labyrinth, called the cochlea, also sends information about sounds to your brain.  

If the organs that control balance of a person's infected ear are inflamed, then the information they send to the brain will be different from the information sent from the unaffected ear.  

Serous Labyrinthitis is the mildest form due to local irritant, such as acute or chronic otitis media without bacterial invasion of inner ear, temporal bone or meningitis.

Histological feature: Eosinophilic staining of the inner ear fluids with or without serofibrinous strands. 

Suppurative labyrinthitis is characterized by the presence of large numbers of  inflammatory cells.

Labyrinthitis Ossificans is end stage of labyrinthitis, with ossification of labyrinthian structures but no inflammatory infiltrate.

The perilymphatic spaces are usually involved and the endolymphatic spaces are often spared.

The region of the scala tympani, near the round window membrane, is the area most commonly affected. 

Labyrinthitis is usually caused by a viral infection.

There is a wide range of viruses that can cause an infection, but the condition often follows a common viral illness such as a cold, the flu, or mumps. 

Viral labyrinthitis may also be due to measles and cytomegalovirus infection.

Viral cytopathic changes are present in scala media.

Labyrinthitis can also be caused by a bacterial infection. Such cases are rare, but likely to be more serious. Bacteria can enter the labyrinth if the membranes (thin layers of tissue ) that separate the middle ear from the inner ear are broken.

This can happen if the patients has middle ear infection (otitis media) or an infection of the brain lining (meningitis).

Bacteria can also gain access to the inner ear as a result of an injury to your ear or head.

It is usually a mild condition that passes within a few weeks, although some cases are more serious and can do permanent damage to your hearing and balance. 

Labyrinthitis can affect people of any age, but it is rare in children.

The main symptom of labyrinthitis is vertigo, a spinning or whirling sensation which a person can feel although neither the person nor his surroundings are moving. 

With labyrinthitis, the vertigo begins suddenly, without warning, and often occurs 1 to 2 weeks after the person recovers from flu or a cold or other viral or bacterial infection.

The sudden onset of vertigo may be severe enough to cause vomiting and nausea. 

The patient may also complain of tinnitus.

Rarely only if the labyrinthitis is caused by a bacterial infection the hearing loss may be permanent.

 

Further reading:

A case of tympanogenic labyrinthitis complicated by acute otitis media.

Temporal bone histopathology in a patient suspected of inner ear extension of otitis media .

Histopathology of labyrinthine fistulae in chronic otitis media with clinical implications.

A human temporal bone study of acute bacterial meningogenic labyrinthitis.

Cytomegalovirus endolabyrinthitis.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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