Progressive vestibular dysfunction in unilateral acute otitis media with serous labyrinthitis: a case report

Objective This study aimed to investigate vestibular function changes in patients with serous labyrinthitis and to discuss the possible mechanisms involved. Patient presentation A 34-year-old female patient of Chinese ethnicity presented with progressive vestibular dysfunction and unilateral acute otitis media complicated by serous labyrinthitis. Upon diagnosis, systemic antibiotic and glucocorticoid therapy was initiated; ceftriaxone sodium (2 g) and dexamethasone (10 mg) were administered via intravenous infusion once daily for 5 days, complemented by hydroxymethazoline and mometasone furoate nasal sprays as adjunctive antiinflammatory measures. Within a week, audiometric thresholds returned to normal, nystagmus intensity progressively diminished, and vertigo resolved entirely. Conclusion Patients with vertigo and labyrinthitis secondary to acute otitis media typically exhibit variable vestibular symptoms, with unidirectional irritative nystagmus serving as a cardinal diagnostic sign. Integration of audiological and vestibular function assessments, including meticulous surveillance of clinical evolution, is paramount to prevent misdiagnosis or treatment delay. The differential impacts of toxic versus inflammatory mediators on inner ear physiology may render early combination therapy with antibiotics and glucocorticoids particularly efficacious.