=Acute Suppurations.=—Acute suppurative diseases of the labyrinth
occasionally result from the extension of infection from the tympanum
but they are certainly very rare. Such conditions may result from
acute suppurative otitis media in which there has been an excessive
collection of pus without rupture of the drum or drainage through
the tube but this very rarely occurs and after drainage has been
established, labyrinthine infection is hardly possible.
=Diagnosis.=—Labyrinthitis is of several forms but in general, there
are the symptoms of labyrinthine involvement such as: nystagmus,
vertigo, nausea, vomiting, headache, earache, deafness and febrile
symptoms. When labyrinthitis is suspected, an aurist of much experience
should be called into consultation at once.
=Treatment.=—Suppurative labyrinthitis is not in itself a fatal disease
but dangerous complications may result because of the close proximity
to so many delicate structures. Threatened meningeal infection requires
surgical drainage, but unless meningeal infection is imminent, surgery
is contraindicated. Since the mortality, considering dangers of
complications, is not high (about 10%) and since such operations are
very complicated and require great surgical skill, we may conclude that
surgery is generally contraindicated.
Non-surgical treatment consists of keeping the patient quiet in bed,
liquid diet, and good elimination. Drainage through the middle ear or
Eustachian tube must be maintained.
Deep manipulation of the cervical structures will help to maintain
lymphatic drainage but any treatment which necessitates much movement
of the head should be avoided until the symptoms of vestibular
irritation have ceased.