L
labyrinthitis An INFLAMMATIONor INFECTIONof the
vestibular system, the body’s balance mechanism
within the inner EAR. The sudden onset of VERTIGO
(feeling of spinning) is the characteristic symptom.
Many people also experience transitory or tempo-
rary hearing problems and TINNITUS(a ringing or
roaring sound). When an infection is present, it
can be viral or bacterial. Bacterial labyrinthitis typ-
ically develops as a consequence of chronic OTITIS
media (middle ear infection). Doctors believe viral
labyrinthitis develops when the bloodstream car-
ries a VIRUS into the inner ear. Inflammatory
labyrinthitis may be an autoimmune condition;
doctors are not certain of its etiology (origin and
development). It is sometimes difficult to diagnose
and distinguish the kind of labyrinthitis because
access to the inner ear is so limited. Often in bac-
terial labyrinthitis there are signs of infection
around the TYMPANIC MEMBRANE (eardrum), or
might be signs of infection elsewhere including
the mastoid (MASTOIDITIS) and less commonly,
MENINGITIS.
Bacterial labyrinthitis has potentially serious
complications, including destruction of the
labyrinth and COCHLEA, which results in permanent
and profound HEARING LOSS. It requires treatment
with ANTIBIOTIC MEDICATIONS. Untreated bacterial
labyrinthitis also can extend into other infections
such as mastoiditis and meningitis. Viral labyrinthi-
tis and inflammatory labyrinthitis generally do not
leave lasting damage. Because distinguishing the
cause of labyrinthitis is sometimes difficult and the
consequences of untreated bacterial labyrinthitis
can be severe, doctors typically prescribe antibiotics
when the diagnosis is unclear, even though antibi-
otics will not treat viral labyrinthitis. Sometimes
medications to suppress vertigo and resulting NAU-
SEAare also necessary, at least until the inflamma-
tion or infection is under control.
See also ACOUSTIC NEUROMA; BACTERIA; BENIGN
PAROXYSMAL POSITIONAL VERTIGO (BPPV); MÉNIÈRE’S
DISEASE; VESTIBULAR NEURONITIS.laryngectomy Surgical removal of the larynx,
which includes the VOCAL CORDSand other struc-
tures that produce sound for the function of
speech. Surgeons perform the majority of laryn-
gectomies to treat CANCERdue to cigarette smok-
ing. Laryngectomy results in the loss of the ability
to speak.
In laryngectomy, the surgeon makes an incision
in the neck and removes the structures of the lar-
ynx, typically including the vocal cords and upper
portion of theTRACHEAas well as surrounding MUS-
CLE tissue to obtain a cancer-free margin. The
ESOPHAGUS, which carries food from the MOUTHto
the STOMACH, remains intact. In the OPERATION’s
final stage the surgeon creates a permanent open-
ing through the neck into the trachea, called a
stoma, for BREATHING.
The operation takes five to eight hours for the
surgeon to perform, and most people stay in the
hospital for 10 to 14 days following the surgery.
Rehabilitation begins immediately and includes
instruction to care for the stoma as well as swal-
lowing exercises. Many people also start to learn
ESOPHAGEAL SPEECH, though speech therapy is most
extensive during outpatient rehabilitation follow-
ing discharge from the hospital. The surgical
wound heals completely in about six to eight
weeks.
Occasionally doctors diagnose the cancer early
enough to permit a partial laryngectomy, in which
the surgeon removes only the tumor and tissues31