Before learning about otitis interna, let us review the basic anatomy of the internal ear to understand the topic easily.
What causes ear infections?
The occurrence of ear infections happens due to viral or bacterial infections that affect the middle ear. It is mostly the sections of the ear behind the eardrum. These infections can cause a lot of pain due to the buildup of fluid and inflammation in the middle section of the ear. There can either be acute or chronic instances of ear infections. Acute ear infections are mostly short-term, but cause a lot of pain, whereas the chronic ones occur multiple times and do not clear up right away. In some instances, if the treatment is not done on time, chronic infections tend to permanently damage the middle and inner ear.
Types of Ear Infections
The following are various types of ear infections:
- Glue ear: Once the infection is cleared, there are chances of the fluid still remaining in the middle ear. This is called as glue ear.
- Otitis externa: When there is an occurrence of inflammation in the ear canal and outer ear, then it is called as otitis externa.
- Herpes zoster: Due to the herpes zoster virus, an infection is developed in the auditory nerves.
- Otitis media: One of the most common types of ear infection is called as otitis media, which can either be chronic or acute. The buildup of fluid in the middle ear is termed as acute otitis media. Frequent instances of acute otitis media can lead to bursting of the eardrum, and in some cases, cause severe damage to the middle ear structures. The condition is then called as chronic otitis media.
- Vestibular neuronitis: This refers to the infection of the inner ear, which can lead to vertigo.
- Infectious myringitis: This refers to the inflammation of the eardrum.
- Acute mastoiditis: This condition happens when acute otitis gets into a complicated stage, wherein the mastoid and the bone behind the ear becomes infected.
The Internal Ear
The internal ear consists of a bony labyrinth, cochlea, and the vestibular system. The two main functions of the internal ear are hearing and balance. The cochlea is a small snail-shaped tube filled with fluid and nerve endings going to the brain. It transmits sound impulses to the brain and is responsible for hearing. The vestibular system consists of semi-circular canals, utricles, and saccules. The receptors of the vestibular system sense the rotation of the head and send impulses to the brain. The main function of the vestibular system is to maintain balance.
What is otitis interna?
Otitis interna is the inflammation of the inner ear. It is also known as labyrinthitis or vestibular neuritis. When the vestibular nerve responsible for balance is inflamed, it is called as vestibular neuritis. On the other hand, when the labyrinth is inflamed affecting the nerve responsible for both hearing and balance, it is known as labyrinthitis. Both of these conditions have the same set of symptoms, and therefore, have the same treatment.
The cause of labyrinthitis is not clear, but it is most frequently caused by a virus and rarely by a bacterium. It usually follows after an upper respiratory tract infection. Sometimes, it can precede a middle ear infection.
The infection will cause the vestibular cochlear nerves to get inflamed and send wrong impulses to the brain that your body is moving. However, your other senses will not detect this such as your vision. This confusion of the signals will make you feel that your environment is spinning or that you have lost your balance.
What are the causes of otitis interna?
- Infections: An instance of viral otitis interna is often followed by a viral upper respiratory tract infection, which is said to be caused by the influenza virus, parainfluenza, or syncytial virus. It is very rare or unusual that bacterial labyrinthitis can be caused by H. influenzae, Proteus, M. catarrhalis, or E. coli. These types of bacteria can cause otitis interna in two ways. The bacteria can directly seep from the surrounding infections such as otitis media, meningitis, or mastoiditis, and called as suppurative labyrinthitis. The second way would be the entry of bacterial contaminants, which goes into the labyrinth and then leads to swelling, which is known as serous labyrinthitis.
- Injury: Injury to the ear, especially the head, can also lead to the occurrence of otitis interna. Another form of injury would be compression, which is caused by a benign growth in the middle ear called as a cholesteatoma.
- Substances: There can be certain cases where few substances or medications can also lead to the occurrence of otitis interna. Certain types of antibiotics, alcohol, diuretics, aspirin, or high levels of phenytoin can also lead to this occurrence.
What are the signs and symptoms of an ear infection?
- Vertigo: this is the most common symptom of labyrinthitis. Vertigo and dizziness are not the same and are frequently confused. Dizziness is the feeling of unsteadiness or lightheadedness, whereas vertigo is the sensation that your surrounding is moving or you are moving. Vertigo is similar to the feeling after going on a merry-go-round.
- Loss of balance: can last for several minutes to hours.
- Nausea or vomiting: vertigo can sometimes become so severe that it will make a person vomit.
- Tinnitus: a ringing or buzzing noise in one's ear.
These symptoms usually appear suddenly but do not last for more than a few weeks.
How are ear infections diagnosed?
Labyrinthitis can easily be diagnosed by taking a clear, detailed history and a complete physical exam. Sometimes, the signs and symptoms of labyrinthitis can mimic other conditions such as migraines, Meniere’s disease (another inner ear problem), brain hemorrhage, stroke, and benign paroxysmal positional vertigo (BPPV, an inner ear disorder). Therefore, your doctor may order additional tests to exclude these possibilities. The tests that your doctor might order are:
- Hearing tests
- CT or MRI scans
- Electroencephalogram (EEG) – a brain wave test
- Electronystagmography (ENG) – an eye movement test
How are ear infections treated?
Labyrinthitis is commonly caused by a viral infection, and therefore, usually goes away on its own within a few weeks. However, if it is a bacterial infection, your doctor will prescribe you some antibiotics. Other medications will also be prescribed to control the symptoms and they include:
- Antiemetic agents: to control nausea and vomiting.
- Steroids: to help you get better soon by reducing the inflammation.
- Sedatives: to help you relax.
Apart from the above-mentioned medications, other simple measures can be adopted to control your vertigo. They include:
- Avoid changing your position quickly or making sudden movements.
- If you are having a vertigo attack, sit still, and hold on for some support until the attack fades away.
- Get up slowly if you are in a lying down or seated position.
Your doctor will also explain to you some simple exercises to practice such as simple head movements and maintaining your balance to reduce vertigo.
Natural Treatments for Otitis Interna
- One should ensure plenty of rest, especially for those suffering from vertigo attacks.
- Avoid doing any strenuous activities, which can lead to the worsening of the condition.
- Avoid taking alcohol, stressful situations, smoking, or certain medications.
- If you are suffering from vertigo, then try doing some light exercises, which can minimize the occurrence of the condition. For example, sit at the edge of the bed and turn your head in the direction wherein you are facing vertigo issues. Slowly lay back with your head still in the same position. Turn your head to 90 degrees facing the opposite direction and hold it there for 30 seconds. Now rotate your body to the side, where your head is pointed, and hold it there for another 30 seconds. Again, sit back up and then repeat this same process for a few more times until you are relieved from vertigo.
- Take over-the-counter medications called as antihistamines.
- If the pain in your ear worsens or is unbearable, then consult an ear specialist immediately for proper diagnosis and treatment.
- One can also try the vestibular rehabilitation therapy. It is a type of physical therapy, which can help the person adapt and correct the symptoms.
Home Remedies for Ear Infections
One can also opt for certain home remedies that can provide some relief. But before trying anything, you can consult the doctor to avoid worsening your existing condition.
- Warm garlic oil: Similar to the same properties of a whole garlic, garlic oil can also be used in a similar manner. Add a few drops of garlic oil in warm water and then place the affected ear in the bowl for around five to seven minutes. You can also directly apply a few drops of the oil directly into your ear. Allow it to sit inside for some time.
- Salt: This is commonly found in most households and can provide relief from ear infections. The process for this home remedy would be to heat up salt in the pan or microwave. Next, put the salt into a cloth and then seal it into a bag. Once the temperature of the bag is at a warm temperature, keep it near the affected ear for about five to ten minutes. This is one good way of relieving pain in the ear and reducing the swelling.
- Lavender oil: Lavender oil is rich with anti-inflammatory properties. The smell of lavender is also great. One can mix lavender oil in a bowl of warm water. Using a clean cotton ball, soak this ball in the mixture and then place it in the affected ear.
- Neem oil: Neem oil is known to be very effective with antimicrobial properties. This would help fight against bacteria and soothe ear inflammation. Neem oil is also known to prevent irritation and itching.
- Onion: Onion is a very common food item, which is known to have multiple medicinal properties that help cure ear infections. Onion juice can be poured into the infected ear or make onion compresses to help relieve the infection.