HomeAnswersOtolaryngology (E.N.T)acute labyrinthitisCan a blow or hit to the ear cause labyrinthitis?

What are the tests to be taken to confirm the diagnosis of labyrinthitis?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At March 18, 2022
Reviewed AtAugust 31, 2023

Patient's Query

Hi doctor,

I am sorry to confess that I ended up hitting an old friend in the ear instead of the head amid a fistfight. It was not a bloody fight or anything, but he said he could not hear properly for a couple of minutes afterward. He had labyrinthitis a few weeks later, and I wonder if that could have been my fault? I have not been in contact with him for a few months now, but I recently started feeling guilty about it again and wondering if I could have done any lasting damage to his ear. How would I know? Please help. Thank you.

Hi,

Welcome to icliniq.com.

Thanks for briefing me regarding the problem in concern. Some amount of hearing loss and tinnitus is expected if there has been trauma to the eardrum. There could have been a rupture of the eardrum due to the impact of the injury. However, such perforations involving the eardrum usually heal in about six to eight weeks if care is taken not to let the ear get infected. The best option to find out is to physically get an otoscopic examination to see the current status of the eardrum. A hearing evaluation can be done after two months if there has been any neurological deficit as far as the integrity of the labyrinth and hearing apparatus is concerned. I hope this answers your query. Please do let us know regarding any further doubts you might have. Warm regards. Thank you.

Patient's Query

Hi doctor,

Thank you for the reply. I worked closely with the person for eight months after the labyrinthitis. I have not been in touch with the person for a while, but I could offer to pay for an ear exam. Would there have been any signs of a serious problem in the following months? Do you think I might have been the cause of the labyrinthitis? Thank you.

Hi,

Welcome back to icliniq.com.

Thanks for reverting. I suggest getting an examination done in the best interest of the patient. Unless there has been a mighty blow, having labyrinthitis is uncommon. Moreover, in labyrinthitis, the patient will have episodes of vertigo and some hearing loss of sensorineural origin. I will not diagnose labyrinthitis if there is no episode of vertigo or clinically documented sensorineural hearing loss. There is a possibility that the patient would have gone to the emergency room, and they would have been diagnosed there. But in the long term, it is very unlikely that labyrinthitis should persist unless something else is causing it. I hope this answers your query. Do let me know regarding further queries. Warm regards. Thank you.

Patient's Query

Hi doctor,

I appreciate your concern. I think you misunderstood my query. I hit the patient, and they reported ear pain afterward and some temporarily reduced hearing (for about 15 minutes). Three weeks later, they repeated ear pain and were diagnosed with labyrinthitis. They supposedly recovered from this after two weeks. We continued working together after that and did not speak of the incident, but I have since wondered if there was any severe damage that I was unaware of. Anyway, perhaps I will make contact and suggest a checkup if you think it is worthwhile. Thank you.

Hi,

Welcome back to icliniq.com.

It is very unlikely that the patient is diagnosed with labyrinthitis just with ear pain as the primary symptom. For making a diagnosis of labyrinthitis, there should be vertigo and documented sensorineural hearing loss. In a nutshell, the trauma could have caused an eardrum perforation, following which the inflammation could have mildly involved the labyrinth (if the patient presented with vertigo and hearing loss). Pain could be due to some ongoing inflammation over the healing eardrum, which is not something grievous and heals within a few days to a maximum of two weeks. I am not sure why they have diagnosed labyrinthitis in a patient presenting with just pure pain and nothing else. It does not fit into the diagnosis. If the patient has no symptoms now, there is absolutely nothing to worry about. Usually, these injuries do not create any lifelong damages, so if you ask me, I do not think you should be worrying too much. But if you are interested, a hearing evaluation and otoscopic examination would be worthwhile to make sure everything is perfectly fine. I hope this answers the query. Warm regards. Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

The patient was diagnosed with labyrinthitis three weeks after the injury (when I punched them). The diagnosis was not due to ear pain alone. They reported starting to feel dizzy one day and some mild ear pain. They took medication and recovered, supposedly. However, even though this happened two years ago, I thought back to the incident and worried that I could have been responsible for some lasting damage. The incident and labyrinthitis both occurred two years ago. I have just been looking back on a few events in my life during that time and I started feeling anxious about problems I could have caused. I guess my question is, how would they tell if the ear was still injured? Thank you.

Hi,

Welcome back to icliniq.com.

If all is fine, there is nothing that you need to worry about. If it has been about an incident that had happened two years back and the patient has not reported any symptoms, it is very unlikely that there should be any damage that has persisted. However, the best way to find out is to get a hearing evaluation done and an otoscopic examination. A high-resolution computed tomography of the temporal bone can also be done to check for any structural abnormality. I would suggest this be done only if there is any abnormality noted on otoscopy and hearing evaluation. I am sure that the ear would have healed as it happens in 99 % of the cases unless there have been any symptoms that have persisted since the incident and have never gone away. Thanks and regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Bhadragiri Vageesh Padiyar
Dr. Bhadragiri Vageesh Padiyar

Otolaryngology (E.N.T)

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