Bacterial Labyrinthitis Following Acute Otitis Media – A Case Series And Systematic Review
Authors List
Blay, Lucy., Wang, A., Department of Otolaryngology Head and Neck Surgery and Audiology, Christchurch Hospital, Christchurch, New Zealand
Quick, M., Bird, P., Department of Otolaryngology Head and Neck Surgery and Audiology, Christchurch Hospital, & Department of Surgery, University of Otago, Christchurch, New Zealand
Introduction
Bacterial labyrinthitis secondary to acute otitis media (AOM) is rare since the advent of antibiotics and immunisations.1 Complications still occur however, with sensorineural hearing loss the most debilitating. Early recognition of clinical symptoms and signs is essential for diagnosis. We discuss four cases of bacterial labyrinthitis and present a systematic review of published cases.
Aim
To evaluate the presentation, clinical factors, pathology and hearing outcomes in patients with bacterial labyrinthitis secondary to acute otitis media.
Method
A retrospective cohort study based on chart review of patients admitted with bacterial labyrinthitis associated middle ear infections between June 2023 to June 2024. The literature was searched from inception through to June 2024 for English language articles documenting bacterial labyrinthitis. Data collected included bacteria identified, inner ear complications, imaging performed and outcome.
Results
Four male patients (mean age 54) were identified. All four patients presented with similar symptoms of AOM with associated vertigo and sensorineural hearing loss. Causative bacteria (Staphylococcus aureus, Streptococcus Group A, Streptococcus Group G) were identified in three patients. All patients had significant sensorineural hearing loss on audiogram at the time of diagnosis. One patient showed progressive improvement in hearing following treatment, whilst the other three had no recovery. Treatment consisted of medical and surgical intervention to minimize inner ear trauma and further complications, as well as hearing rehabilitation.
Conclusion
Early diagnosis and treatment with corticosteroids and decision for surgical intervention can assist with preserving audiological and vestibular function. The assessment hearing recovery is crucial and needs close observation post diagnosis. Continued education and research are required to further improve early recognition, diagnosis, and intervention in cases of bacterial labyrinthitis, and thus reduce potential complications.
References
Maranho AS de A, Godofredo VR, Penido N de O. Suppurative labyrinthitis associated with otitis media: 26 years’ experience. Braz J Otorhinolaryngol. 2016;82(1):82-87
Blay, Lucy., Wang, A., Department of Otolaryngology Head and Neck Surgery and Audiology, Christchurch Hospital, Christchurch, New Zealand
Quick, M., Bird, P., Department of Otolaryngology Head and Neck Surgery and Audiology, Christchurch Hospital, & Department of Surgery, University of Otago, Christchurch, New Zealand
Introduction
Bacterial labyrinthitis secondary to acute otitis media (AOM) is rare since the advent of antibiotics and immunisations.1 Complications still occur however, with sensorineural hearing loss the most debilitating. Early recognition of clinical symptoms and signs is essential for diagnosis. We discuss four cases of bacterial labyrinthitis and present a systematic review of published cases.
Aim
To evaluate the presentation, clinical factors, pathology and hearing outcomes in patients with bacterial labyrinthitis secondary to acute otitis media.
Method
A retrospective cohort study based on chart review of patients admitted with bacterial labyrinthitis associated middle ear infections between June 2023 to June 2024. The literature was searched from inception through to June 2024 for English language articles documenting bacterial labyrinthitis. Data collected included bacteria identified, inner ear complications, imaging performed and outcome.
Results
Four male patients (mean age 54) were identified. All four patients presented with similar symptoms of AOM with associated vertigo and sensorineural hearing loss. Causative bacteria (Staphylococcus aureus, Streptococcus Group A, Streptococcus Group G) were identified in three patients. All patients had significant sensorineural hearing loss on audiogram at the time of diagnosis. One patient showed progressive improvement in hearing following treatment, whilst the other three had no recovery. Treatment consisted of medical and surgical intervention to minimize inner ear trauma and further complications, as well as hearing rehabilitation.
Conclusion
Early diagnosis and treatment with corticosteroids and decision for surgical intervention can assist with preserving audiological and vestibular function. The assessment hearing recovery is crucial and needs close observation post diagnosis. Continued education and research are required to further improve early recognition, diagnosis, and intervention in cases of bacterial labyrinthitis, and thus reduce potential complications.
References
Maranho AS de A, Godofredo VR, Penido N de O. Suppurative labyrinthitis associated with otitis media: 26 years’ experience. Braz J Otorhinolaryngol. 2016;82(1):82-87
