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Labyrinthitis ossificans with fluctuating symptoms lasting for more than 10 years: a case report and literature
Jing Wang1,2,3, Wenjuan Li1,2,3, Yinghui Hu1,2,3
1Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
Background:
Labyrinthitis ossificans (LO) is the end stage of labyrinthitis. Existing case reports primarily center around hearing loss and overlook a crucial aspect that patients with LO frequently experience balance problems, while our study fills this gap. We report a rare case of bilateral labyrinthitis secondary to meningitis with recurrent fluctuations in cochlear and vestibular symptoms over more than a decade, and incomplete ossification of the labyrinth.
Case Description:
An 8-month-old female patient was diagnosed with meningitis, and later experienced developmental delays and hearing issues. By 4-5 years, she had complete sensorineural hearing loss in the left ear. At 13 years, she started to experience problems in the right ear, such as hearing decline and aural fullness. Computed tomography and gadolinium-enhanced magnetic resonance imaging showed specific inner ear changes, and a decline in vestibular function. During the treatment course, the patient initially demonstrated an improvement in right - ear hearing. Nevertheless, her auditory function subsequently deteriorated, ultimately underwent cochlear implantation surgery. Fortunately, following the comprehensive treatment regimen, the patient's balance function recovered, and symptoms of dizziness ceased to recur.
Conclusions:
This patient suffered from a rare form of labyrinthitis with fluctuating cochlear and vestibular symptoms over an extended course of illness. Despite the temporary effectiveness of corticosteroid treatment during the process, cochlear implantation was ultimately required. During the treatment, we paid special attention to the patient's vestibular function and observed a significant decline in bilateral vestibular function. Based on the examination results, we have provided more comprehensive treatment and lifestyle recommendations to better ensure her safety during activities.
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