Inner Ear Conditions

What is Inner Ear?

The inner ear comprises the cochlea (snail looking structure) and semi-circular canals (part of our balance system). The cochlea contains an amazingly complex array of some 30,000 inner and outer hair cells (or nerve endings) which establish an ear/brain interaction to enable us to decipher speech sounds in the most compromising of situations - for example being able to have a conversation in a noisy café, where speech sounds are embedded in other speech sounds. The nerve transmitting to the brain is the eighth of twelve cranial nerves which allow our brain to interact with our sensory input/output system.

Inner Ear Structure

Inner Ear Conditions

Inner ear conditions are uncommon. Among the most common conditions affecting the inner ear are viral labyrinthitis. Viral labyrinthitis is a condition characterised by a sudden loss of hearing and/or sudden onset of balance disturbances often following a viral upper respiratory tract infection. Sometimes, there is no clear anticedent history of an infection. The patient usually has no systemic signs, there is no fever, there is no earache, but they become aware of one of 2 symptoms; either decreased hearing loss or rotational disequilibrium/vertigo.

Viral labyrinthitis is clinically impossible to differentiate from vestibular neuronitis and/or a post-viral mononeuritis affecting the hearing branch of the eighth cranial nerves. These situations all present with a sudden onset of major symptomology, there may or may not have been an anticedent history of infection. Treatment is expected. If seen in the first 72 hours, it is not uncommon for oral steroids to be prescribed. Although there is a theoretical benefit to the prescription of oral steroid insomuch as they act as non-specific anti-inflammatory ages, an analysis of evidence in the literature shows that there is no demonstrable benefit from the use of steroids.

Oral antiviral agents such as Acyclovir and/or parenteral use of anti-viral agents, again has some theoretical application but analysis of the literature again shows that there is no demonstrable benefit from the addition of these agents. Treatment is usually expectant, and resolution of symptoms occurs in the majority of cases.

Another inner ear condition is too much fluid pressure in the ear or endolymphatic high drops. If no clear cause for this is found, it is called Meniere’s Disease. The classic triad of symptoms in Meniere’s disease is fullness in the ear, loss of hearing, dizziness plus or minus ringing in the ears. Characteristically, attacks of Meniere’s disease are relatively short-lived lasting hours rather than days, with complete resolution of symptoms, in the majority of cases, between these acute attacks. The attacks tend to come in clusters with long remission periods.

There is often a strong family history of Meniere’s disease.

Objective analysis of Meniere’s disease or proving the diagnosis involves a variety of technical ways of measuring fluid pressure in the inner ear by a test known as electrocochleography. Sometimes, there are radiological abnormalities that can be discerned on CAT scans with regards to the fluid containing reservoirs in the inner ear like the endolymphatic sack of the vestibular aqueduct.

The treatment of Meniere’s disease, in most cases, is medical and involves medication to reduce the amount of fluid (diuretics), the avoidance of salt and mediations as required to control specific symptoms.

If you are suffering from any inner ear conditions, please contact Havas ENT Clinics for help. You can either book an appointment online or call us on 02 9387 7360

If you doubt you have any conditions on outer ear or middle ear, please find the information here: