The labyrinth is the medical terminology for the balance portion of the inner ear. The inner ear consists of a complex area in the temporal bone and can be divided into three parts: the vestibule (in the middle), cochlea (in front), and semicircular canals (in the back). All three parts form a continuous and tortuous space containing different fluids (endolymph, perilymph, and cortilymph), and each are separated by delicate membranes. The hearing portion of the inner ear is the cochlea. The balance portion, or labyrinth, consists of the vestibular endorgans in the semicircular canals . Any abnormality that is related to either the function of the labyrinthine or the labyrinthine sensors is considered a labyrinth dysfunction. In most situations with labyrinthine dysfunction, the labyrinth does not properly respond to movement changes of the body.
The causes of labyrinthine dysfunction can vary greatly: however, some of the leading causes are:
– Prior ear surgery (Less frequent with newer techniques)
– Head trauma, including whiplash injuries
– Barotrauma (scuba diving or sudden pressure changes to the inner ear)
– Acoustic trauma
– Idiopathic or unknown cause without any underlying factors
The diagnosis of labyrinthine dysfunction is based upon both the patient’s subjective complaints and diagnostic testing. Generally, patients will complain of vestibular symptoms, (vertigo-with or without head position changes, dysequilibrium, motion intolerance, nausea, and vomiting), disorganization of memory and concentration, and/or perceptual disorganization in complex surroundings such as crowds or traffic. Diagnostically, patients will present with abnormal positive test results for vestibular dysfunction. The patient may not be able to stand with their feet together (Romberg test) and remain still, nor are the able to perform a more difficult test of having the feet heel-to-toe (Tandem Romberg).
There are a number of tests that can be helpful in identifying the exact nature of a patient’s labyrinthine dysfunction.
Neurotologists at EIT may use: ENG, ECoG, Audiogram, or ABR testing. Additional testing may include a CT scan or MRI scan.
The final diagnosis is made by your physician who will evaluate both the symptoms as well as the causes of the symptoms. Treatments can range from medical therapy, home exercises, physical therapy, or a combination. In a few cases, surgery may be needed to resolve the dizziness.