Labyrinthitis in Children

What is Labyrinthitis in Children?

Labyrinthitis is an inflammatory disease of the inner ear. The development of the disease occurs due to the effects of infection, pathogenic microorganisms on the inner ear. With labyrinthitis, the peripheral receptors of the auditory and vestibular analyzer respond to damage, the functions of the organs of hearing and balance are impaired. With labyrinthitis, not only the inner ear, but also the middle one is often affected.

Causes of Labyrinthitis in Children

The cause of the disease is a viral or bacterial pathogenic flora, the effect of toxins on the body, as well as various types of ear injuries. Labyrinthitis is divided into non-specific and specific (tuberculous, syphilitic). The causes of the development of the disease include:

  • The introduction and spread of viruses in the inner ear, which provoke labyrinthitis, with the help of blood flow (streptococcus, tuberculosis, syphilis, etc.).
  • The location of the meningitis focus near the inner ear.
  • The penetration of infection through the meninges, the internal auditory canal and the water supply of the cochlea.

Pathogenesis during Labyrinthitis in Children

For pathological indicators, labyrinthitis is divided into: serous, purulent and necrotic.

Serous labyrinthitis is characterized by the development of endolymphatic edema, accompanied by purulent inflammation of the membranes of the inner ear, while nerve elements are damaged. There is a swelling, vacuolization and decay of the neuroepithelium. Serous labyrinthitis can be a complication of chronic suppurative otitis media.

During necrotic labyrinthitis, soft tissue necrosis occurs, capsules of the labyrinth with inflamed areas, and the bony walls of the labyrinth. Such a process goes into labyrinth sclerosis. Inflammation extends partially or completely to the labyrinth.

If the patient is diagnosed with purulent labyrinthitis, the development of the disease occurs in the following way: polymorphonuclear leukocytes and bacteria accumulate in the perilymphatic space, while the vessels expand, after which the edema increases in volume and passes into necrosis of the membranous and bone walls of the labyrinth tissue. Such a process destroys all receptors and nerve elements.

Depending on the route of infection into the inner ear, labyrinthitis is divided into:

  • Tympanogenic is the most common form of this disease. It penetrates the body from the cavities of the middle ear, destroying the bony walls of the labyrinth, or through the window of the cochlea and vestibule.
  • Meningogenic – develops in children with epidemic meningitis. It is caused by an infection that penetrates from the subarachnoid space along preformed pathways through the internal auditory canal and perilymphatic duct. This form of labyrinthitis can occur in people who suffer from tuberculosis, flu, scarlet fever, measles and typhoid. The pathogens also include: pneumococcus, pale triponema, meningococcus, mumps, etc. This type of labyrinthitis is often purulent or serous. As a rule, both ears are susceptible to damage.
  • Hematogenous – the infection penetrates the hematogenous route (blood flow). This can occur in patients with common infectious diseases of predominantly viral origin, for example, influenza, mumps.
  • Traumatic – appears in violation of the bone and membranous labyrinth.

The inflammatory process can affect the entire maze or only certain sections. Based on this, the labyrinthitis is divided into diffuse and limited. The first type is observed in children with chronic purulent epithympanitis, which is complicated by caries and cholesteatoma. A fistula often appears in the bone capsule of the labyrinth, which by its size reaches the inner wall of the capsule. At this point, in response to inflammation, a granulation shaft appears, which prevents the further penetration of the infection. Such a labyrinthitis has a chronic course and with its progression of the inflammatory process can go into diffuse.

With labyrinthitis, various morphological changes occur in the body: for example, labyrinthitis can manifest itself in the form of temporal bone osteitis. The patient has a depletion of epithelial cells of the inner ear, the walls of the maze swell. Maze edema is caused by accumulated pathogenic bacteria and white blood cells, for which timely treatment has not been carried out. Such a process causes severe swelling and tissue necrosis.

With labyrinthitis, the patient has atrophy of soft tissues and focal localization of the infection, which can spread widely.