The Pathology of Inflammatory Diseases of the Labyrinth

Max Görke
1911 The Journal of Laryngology Rhinology and Otology  
translation by DAN -MCKENZIE.) INFECTIVE labyrinthitis is, of course, generally secondary either to meningitis or to otitis media. It is true that cases of primary labyrinthitis have been reported, but it is probable that such cases are more apparent than real, and that they are due to abortive forms of meningitis passing on to infect the labyrinth by way of the aqiueductus cochlea?, the communication between the subarachnoid spaces and the perilymphatic system of the labyrinth. Even the
more » ... s of epidemic mumps has been referred to such a transitory attack of eerebr.>-spinal meningitis (Brieger). Causal Disease.-Apart from epidemic cerebro-spiual meningitis, the labyrinth is seldom attacked from the cranial side; most cases of infective labyrinthitis are secondary to middle-ear suppuration. With regard to the question whether acute or chronic middleear suppuration is the more dangerous to the labyrinth, the author's investigations have shown that, if we include tuberculosis and cholesteatomatous disease, the chronic is the more frequent precursor of labyrinth infection. For of all the varieties of middle-ear suppuration, tuberculosis is the most common cause of labyrinthitis, while cholesteatoma comes next. It should be noted that both these varieties lead to septic infection of the labyrinth. In the simple septic types of suppuration of the middle-ear spaces the infection of the labyrinth generally takes place during an acute exacerbation of the tympanic disease, and this is not infrequently excited by trauinatism, such as the removal of polypi, curetting, etc. Notwithstanding the greater tendency of chronic middle-ear disease to attack the labyrinth, there is also, nevertheless, considerable danger of this complication arising in acute suppuration, especially in that form which accompanies scarlet fever. Routes of Infection.-The labyrinth stands in more direct continuity with the meninges than with the middle ear, consequently meningitis is more prone to lead to labyrinthitis than is disease in the middle ear, the respective percentages being from 15 to 50 of the former and 1 of the latter. 1 From Archivfiir Ohrenheilkunde, Bd. lxxx, Heft. 1 und 2, p. 1.
doi:10.1017/s1755146300186810 fatcat:kpjnp3barzfuxmasvgm2fk6dda