Went to the docs and he wasn't concerned and said it'll clear up on its own. :pig:
Management[8]
If the patient presents with sudden-onset unilateral deafness, admission to hospital or urgent assessment by an ear, nose and throat specialist should be considered. The reasoning for this is that such deafness can be indicative of acute ischaemia of the labyrinth or brainstem. Emergency treatment in such cases can restore the patient's hearing.
Otherwise, the patient can usually be managed at home. During an acute attack the patient should lie still with eyes closed.
Patients should be advised to seek further medical care for worsening symptoms - especially neurological symptoms (such as diplopia, slurred speech, gait disturbances, localised weakness or numbness).[14]
Vertigo, nausea and vomiting may be helped by prochlorperazine, promethazine and domperidone. In an acute attack, gastric emptying will be slowed or even reversed and so a buccal version of prochlorperazine may be preferable.
Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant.[15]
A short course of oral corticosteroids may be helpful.[16]
Currently, the role of antiviral therapy is controversial.[1]
Always advise patients not to drive or operate machinery when experiencing symptoms or taking medication, as appropriate.
Surgical treatment may be necessary - eg, myringotomy and evacuation of effusion in labyrinthitis secondary to otitis media and mastoidectomy for mastoiditis or cholesteatoma.
Complications
Although the labyrinthitis is usually considered benign and self-limiting, chronic or recurrent cases merit referral to exclude sinister aetiology. Also the morbidity of labyrinthitis, especially bacterial labyrinthitis, is more significant than is often appreciated. In the paediatric population the risk of hearing loss is significant.
Prognosis
The acute symptoms of vertigo and nausea and vomiting resolve after several days to weeks in all the different types of labyrinthitis.
Recovery of hearing loss is more variable:
Suppurative labyrinthitis usually leaves permanent and profound hearing loss.
Hearing loss associated with viral labyrinthitis may recover. Disequilibrium and or positional vertigo also may be present long-term following resolution of the acute infection.
Permanent hearing loss is a recognised complication of children with meningitis. Dexamethasone may have some protective effect against this complication but the evidence is equivocal.[17]
Permanent hearing loss occurs in about 10% of patients with herpes zoster oticus.[18]
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Practice tips
It is important:
Not to miss a potentially life-threatening condition, such as meningitis, cerebrovascular ischaemia, or brainstem tumour. Chronic or recurrent cases should be referred.
To counsel patients not to drive or operate machinery when suffering from vertigo or taking medication for symptoms.
