labyrinthitis
Introduction
Introduction to labyrinthitis Labyrinthitis, also known as otitis media, is a common complication of suppurative otitis media. The inner side wall of the middle ear and the mastoid is adjacent to the inner ear. The inner bone wall of the middle ear mastoid is the bone wall of the inner ear. Therefore, when the middle ear mastoid has purulent inflammation, especially the middle ear mastoid that destroys the granulation. Inflammation of the inner ear is easily caused by the inner ear bone wall eroded by inflammation during inflammation. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: tinnitus, deafness
Cause
Cause of labyrinthitis
1. After the virus infection, the serum was determined, and the herpes simplex and herpes zoster virus titers were significantly increased.
2. The vestibular nerve is stimulated by the vestibular nerve to undergo vascular compression or arachnoid adhesions, and even due to stenosis of the internal auditory canal caused by hypoxia-induced degeneration, which is caused by stimulating nerve discharge.
3. The disease factor may have an own immune response.
4. Diabetes Schuknecht et al (1972) reported that diabetes can cause degeneration of vestibular neurons, leading to repeated vertigo attacks.
Prevention
Labyrinth prevention
This disease is a common complication of suppurative otitis media. Therefore, active treatment of suppurative otitis media is the key to prevent this disease. Patients with this disease need to be hospitalized for anti-inflammatory, symptomatic support and surgical treatment to completely eliminate the source. Localized labyrinthitis, such as normal inner ear function, does not scrape the cholesteatoma epithelium of the labyrinth of the scapular fistula, so as to avoid the occurrence of acute purulent infection: if the fistula is opened during surgery, it should be closed with fascia or vein. Diffuse suppurative labyrinthitis is performed with a labyrinth to prevent intracranial complications.
Complication
Labyrinth complications Complications, tinnitus and deafness
This disease is a common complication of suppurative otitis media, which can eventually lead to tinnitus and deafness.
Symptom
Sympathy symptoms common symptoms tinnitus and deafness nausea dizziness hearing loss leukocytosis
First, localized labyrinthitis:
1. Paroxysmal or stimulating vertigo, occasionally accompanied by nausea, vomiting, vertigo, more rapid turn, flexion, driving, operation in the ear (such as earing, ear washing, etc.), pressing on the tragus or blowing nose, continuous The symptoms range from a few minutes to a few hours, and the symptoms of acute mastoid mastitis are exacerbated.
2. Spontaneous nystagmus can be seen in the onset of vertigo, and the direction is toward the affected side. This is the reason that the affected side is in a state of stimulation.
3. Hearing loss: The nature and extent of deafness are consistent with the degree of otitis media, and the fistula is located in the sputum.
4. The fistula test is positive, and the fistula can be negative when blocked by pathological tissue.
5. The function of the vestibule is generally normal or hyperactive. It is not advisable to use the hot and cold water test during the inspection to avoid the spread of infection.
Second, serous labyrinthitis:
1. Dizziness, nausea, vomiting, and balance disorders are the main symptoms of the disease. The patient is lying on the affected side (the side of the eye movement is fast), and is tilted to the healthy side when standing up.
2. The nystagmus is horizontal-rotating, and the lost side is in a state of excitement and irritability. Therefore, the nystagmus is fast toward the affected side, and the late-stage occultation function is significantly reduced. The nystagmus is pointing to the healthy side, and the vestibular function is different. The decline may be positive for the fistula test.
3. The hearing is obviously reduced, which is a sensorineural hearing loss. But not all.
4. There may be deep pain in the ear.
Third, suppurative labyrinthitis:
1. Dizziness, conscious foreign objects or self-rotation, nausea, frequent vomiting, patients closed their eyes, curled side lying on the side of the eye movement, do not dare to move.
2. Balance imbalance.
3. Tinnitus, suffering from full ear.
4. Spontaneous nystagmus, fast-moving to the healthy side, the intensity is large, and the trunk is tilted to the slow side of the nystagmus. When the nystagmus is moving from the healthy side to the affected side, the possibility of intracranial complications should be guarded.
5. The body temperature is generally not high, if there is fever, headache, accompanied by cerebrospinal fluid changes (such as leukocytosis, increased cerebrospinal fluid pressure, the infection spread to the brain.
6. Because the lost path has been destroyed, the fistula test is negative.
Examine
Labyrinth examination
Cochlear electrogram, ear examination, otoscopy, Otolaryngology CT examination.
1. Partial or complete loss of vestibular function in the hot and cold temperature test, sometimes biased towards the healthy side.
2. Blood cells can increase in the acute phase.
Diagnosis
Diagnosis of labyrinthitis
(a) localized labyrinthitis
1. A long-term history of chronic suppurative otitis media, especially in patients with cholesteatoma formation, bone destruction and granulation of otitis media.
2. Symptoms and signs of paroxysmal or stimulating vertigo, accompanied by nystagmus.
3. Examination: Hearing loss, fistula test is generally positive, and vestibular function tests are mostly normal or hyperactive.
(two) serous labyrinthitis
1. History: history of purulent middle ear mastoiditis.
2. Symptoms: persistent dizziness and balance disorders, hearing loss significantly.
3. Signs: Spontaneous nystagmus, horizontal-rotation.
(three) suppurative labyrinthitis
1. History: history of suppurative middle ear mastoiditis.
2. Symptoms: Severe dizziness, hearing loss.
3. Signs: Spontaneous nystagmus. There was no response in the ear cold heat test and the fistula test.
