What Is an Inner Ear Infection, and How Is it Treated? - GoodRx (2024)

There are three categories of ear infections based on the part of the ear that is affected. When most people talk about an ear infection, they’re likely thinking of a middle ear infection. Swimmer’s ear — an infection of the outer ear — is also common. Inner ear infections are the least common, and so people are less familiar with the symptoms. But the symptoms can be quite disconcerting.

To understand inner ear infections, let’s first examine the parts of the inner ear. It consists of three main parts:

• The cochlea: This is the part of the ear that helps the body hear sounds.

• The vestibule and semicircular canals: These structures are important for balance.

Sometimes, infections — either viral or bacterial — can cause inflammation of the nerves and structures of the inner ear. When that happens, it can affect both our balance and hearing.

What are symptoms of an inner ear infection?

There are two types of inner infections:

• Vestibular neuritis is an infection of the vestibule and semicircular canals.

• Labyrinthitis is an infection of the entire inner ear, including the cochlea.

Unlike middle and outer ear infections, pain is not a symptom of inner ear infections. Vestibular neuritis leads to dizziness, nausea and vomiting, and inability to balance. This is called vertigo and can often make you feel as if the room is spinning. Vertigo is often worse when you move your head, stand up, or try to walk. Getting out of bed and walking to the bathroom might feel impossible.

Labrynthitis can lead to vertigo, just like vestibular neuritis. But because it also affects the cochlea, it can lead to hearing changes as well. This can be a ringing in the ears or temporarily decreased hearing. Sometimes the hearing loss is subtle, and you might not realize your hearing is different.

How is an inner ear infection diagnosed?

Inner ear infections are usually diagnosed based on your symptoms and a physical exam. Many times, a healthcare provider can diagnose an inner ear infection on symptoms alone. And that’s good, because it’s impossible to directly look at the inner parts of the ear on a physical exam. Your provider may also examine your eyes, because certain eye movements get affected when our balance is a little off.

Most of the time, no specific testing is needed to diagnose an inner ear infection. But if the diagnosis is a little less certain, it’s possible that your provider will recommend an additional evaluation. This may include:

• Imaging of your head, such as a CT scan or an MRI

• A formal hearing test to see if that is also affected

• A referral to an ear, nose, throat (ENT) specialist

How is an inner ear infection treated?

Inner ear infections are mostly caused by viruses, so there is no role for antibiotics (which treat bacteria). But the good news is that the infection usually resolves on its own in a few days.

And while you are recovering, there are medicines that can help decrease your symptoms:

• Antiemetics: These are medicines that help with nausea and vomiting. Examples include ondansetron or promethazine.

• Antihistamines: These include diphenhydramine (Benadryl) or meclizine. In addition to helping the dizziness, these medicines can also help you get some much-needed rest.

Sometimes, steroids are prescribed to decrease the inflammation from inner ear infections. But there is no convincing evidence that shows this helps, and so this treatment remains controversial.

What’s the bottom line?

Inner ear infections — both vestibular neuritis and labyrinthitis — are usually viral infections that resolve on their own. Although the diagnosis is usually an easy one to make, it is still a good idea to see your healthcare provider when experiencing these symptoms. They can rule out other possible conditions and also provide recommendations for medicines that will make your recovery more comfortable.