Depending on the structure of the inner ear, which is affected by an inner ear infection, the affected person shows different symptoms. Early therapeutic measures often positively influence the healing process.
What is inner ear inflammation?
The inner ear inflammation is also called labyrinthitis in medicine. Inner ear inflammation can affect various structures in the inner ear, which include, for example, the so-called cochlea (which, in conjunction with the brain, provides an impression of hearing in humans) and the organ of balance. Depending on the area of the inner ear that is affected by inflammation, the affected person may experience different symptoms. Symptoms of inner ear inflammation include, for example, ear pain, tinnitus (in which the affected person perceives sounds even though there is no external sound source) and hearing loss, as well as nausea and dizziness. If an inner ear infection is severe or if it is not treated sufficiently medically, any hearing loss that occurs can also result in complete hearing loss.
Causes
Inner ear inflammation can have various causes. For example, the inflammation can either originate directly in the inner ear or spread to the inner ear from other areas of the ear (such as the middle ear). Possible external causes of inner ear inflammation include injuries to the ear or surgical procedures performed on the ear. An inner ear infection caused by infections in other parts of the body is caused, for example, by bacteria or viruses:
If there are germs in the blood, they can reach the inner ear via the meninges and auditory nerve and cause an inflammation. If an inner ear infection is bacterial, it is usually caused by an existing middle ear infection or meningitis (an inflammation of the meninges) that spreads to the inner ear. Possible causes of viral inner ear inflammation include inflammation of the upper respiratory tract (i.e., such as the nose or sinuses) that spreads to the inner ear.
Symptoms, complaints, and signs
Inner ear inflammation is primarily manifested by severe ear pain. The pain usually occurs in connection with a cold or flu and develops gradually. In the course of the disease, hearing problems and even hearing loss may develop. Many affected persons suffer from tinnitus or dizziness. Nausea and vomiting as well as a general feeling of malaise often accompany the disease. If the inner ear inflammation progresses further, the complaints increase and there is a risk that the inflammation will spread to surrounding areas of the body. In the worst case, the affected person loses hearing completely. Due to the hearing problems and the persistent pain, sleep disturbances often occur, which can cause fatigue, irritability and comparable secondary symptoms. In individual cases, the inner ear inflammation spreads to the middle ear, from which a serious infection can develop. Externally, inflammation of the inner ear cannot usually be detected. However, a slight redness may be seen in the area of the ear entrance, and occasionally fluid also leaks from the ear. If treated early, the symptoms and discomfort will resolve on their own after a few days. Hearing symptoms may persist for several days to weeks after recovery.
Diagnosis and progression
Inner ear infection can cause severe ear pain. To diagnose an existing inner ear infection or to identify the inner ear organs affected by the inflammation, various diagnostic procedures must be used. These procedures include, for example, the so-called otoscopy (ear examination); otoscopy enables the treating physician to view the external auditory canal with a medical instrument. With the aid of so-called audiometry (the measurement of hearing ability by means of hearing tests), any hearing loss caused by an inner ear infection can be checked. Other diagnostic options for checking an inner ear infection include, for example, balance examinations or the performance of so-called imaging procedures (such as computer tomography/CT). The course of inner ear inflammation differs depending on the patient and the severity of the inflammation.The healing process of an inner ear infection can vary between a few days and several months. Often, an inner ear infection causes severe symptoms, especially during the first few days, which then increasingly subside. Persistent damage, such as dizziness, is rare but possible.
Complications
In most cases, inner ear infection can be treated relatively well if treatment is initiated early. This also does not result in any particular complications or discomfort, and no secondary damage occurs. In most cases, those affected by inner ear inflammation suffer from severe ear pain and, as the disease progresses, also from hearing loss. If there is no treatment, the affected person may lose hearing completely. Likewise, there may be noises or tinnitus in the ear. These noises significantly reduce the quality of life and can also cause sleep problems at night. It is not uncommon for the patient to also be irritable and suffer from nausea due to the inner ear inflammation in general. Diagnosis of this inflammation is usually relatively simple, so that early treatment is also possible. The treatment of inner ear inflammation is carried out with the help of medications and antibiotics. Complications do not occur and the symptoms can be well limited. However, the affected person must take care of his ear. There is no permanent damage and the life expectancy is also not reduced by this inflammation.
When should one go to the doctor?
Sudden onset of dizziness, unsteadiness of gait or vomiting, indicate health discrepancies. A doctor should be consulted as soon as these symptoms persist for several days or occur repeatedly. In case of ringing in the ears, tinnitus or numbness, it is necessary to have a check-up as soon as possible. Decreased hearing, balance problems or uncontrolled eye movements are cause for concern. A doctor should be consulted so that the complaints can be clarified. If there is pain in the ear or head, a feeling of pressure inside the head or a pulling sensation in the ear, a doctor should be consulted. If existing pain increases or sleep disturbances as well as attention deficits set in, a medical examination must be initiated. If an unusual amount of secretion accumulates in the ear or if this secretion smells strange, a visit to the doctor is necessary. If existing complaints spread or increase in intensity, a doctor should be consulted. If the daily performance requirements can no longer be met or if there are problems with the performance of sporting activities, a doctor must investigate the complaints. If the inflammation spreads, the affected person is threatened with lifelong impairments without treatment. Therefore, a visit to the doctor is recommended already at the first discrepancies. In case of itching in the ear, differences between the ears in hearing perception and changes in speech, a doctor is needed.
Treatment and therapy
Individual therapy for inner ear infection can be done in several ways. Acute symptoms of inner ear inflammation, for example, can be treated with medication; medications used here include pain-relieving and/or anti-inflammatory drugs. In order for medications to be used effectively, it is first important to know whether an inner ear infection in the affected person is caused by bacteria or by viruses: If bacteria are responsible for inner ear inflammation, antibiotics can be used. If, on the other hand, viruses have caused the inflammatory processes, physicians often prescribe antiviral drugs. If the inflammation is neither viral nor bacterial (for example, as a result of injury), drug treatment may be limited to anti-inflammatory agents. Drug treatment of inner ear inflammation can be supplemented, for example, by infusions with a circulation-promoting effect. If an inner ear inflammation is accompanied by prolonged vomiting, this can lead to high fluid loss; in this case, a short-term hospital stay may be appropriate in individual cases. If meningitis has led to inner ear inflammation, surgical intervention may be necessary in severe cases.
Outlook and prognosis
Inner ear inflammation can be treated well. If the inflammation is caught early, the outlook for a speedy recovery is good.However, typical symptoms such as pain or impaired hearing may persist for a few days. In addition, the prescribed anti-inflammatory drugs can sometimes cause side effects. In this case, the patient may have to take alternative therapeutic measures. In general, however, the prognosis is positive. Only if treatment is inadequate or absent can serious complications arise. Inner ear infection can spread to the middle ear and surrounding regions, resulting in hearing loss. In severe cases, this hearing loss is permanent, resulting in severe limitations in daily life and often psychological problems. Labyrinthitis in children has a somewhat worse prognosis because the auditory canals are still growing. In severe cases, permanent damage occurs, permanently reducing hearing ability. Risks also exist in pregnant women and in people with pre-existing conditions such as immunodeficiency or an existing hearing impairment. These high-risk patients can improve the prospect of a full recovery by having the inner ear infection promptly evaluated.
Prevention
One way to prevent inner ear infection is to treat other inflammatory conditions in the head early. In order to counteract an aggravation of the symptoms and/or possible longer-term or long-term consequences in the case of an already existing inner ear inflammation, an early visit to the doctor (already at the first symptoms) is especially important.
Follow-up care
After the inner ear infection has been cured, patients must have a final medical examination. The otolaryngologist will check the inner ear one more time to detect any inflammation, secretions, or redness. Lastly, a patient interview will be conducted to clarify any unanswered questions and to ensure that the inner ear infection has completely resolved. In most cases, further follow-up examinations are not necessary. In the case of chronic labyrinthitis, the patient and physician must consult closely, as the nature and intensity of symptoms can vary greatly. In particular, sleep disturbances and gastrointestinal complaints must be monitored by a physician if they recur. In the long term, other conditions may be added and lead to massive restrictions in the quality of life. Patients should therefore consult closely with a medical professional. As part of the aftercare, which is provided by the responsible ENT physician, medications such as painkillers or anti-inflammatories may need to be taken. Accompanying this, successful aftercare always includes prevention. Labyrinthitis can quickly develop into a chronic disease if possible causes such as poor personal hygiene or constant exposure of the inner ear to noise are not eliminated. The triggers must be identified and corrected.
What you can do yourself
In the case of labyrinthitis, it is important that the symptoms are interpreted correctly and that adequate treatment is started as soon as possible. The patient himself can best contribute to this. An inner ear inflammation must under no circumstances be downplayed and exclusively treated by oneself. Anyone who notices severe dizziness, nausea and impaired hearing should not dismiss this as the onset of a cold, but should consult an ear, nose and throat specialist immediately. If labyrinthitis is diagnosed, the patient should take it easy for some time and, if possible, stay in bed. This also reduces the risk of accidents, which is greatly increased in labyrinthitis because the vestibular organ is often affected. In addition to the treatment prescribed by a doctor, many patients find heat very helpful in relieving pain and feelings of pressure in the ear. For this purpose, the ear can be irradiated with red light or simply a hot potato wrapped in a towel can be applied. The ears should also be spared during this time. Reading is therefore a better pastime than watching loud television or playing noisy video or computer games. The use of headphones and earplugs should also be avoided until the middle ear infection has healed.
