The key distinguishing feature between vestibular neuritis and labyrinthitis is:

• A Vestibular neuritis presents with isolated acute vestibular syndrome without hearing loss, while labyrinthitis involves concurrent cochlear and vestibular dysfunction with sensorineural hearing loss ✓
• B Vestibular neuritis is bacterial while labyrinthitis is always viral in aetiology
• C Vestibular neuritis is always unilateral; labyrinthitis is always bilateral
• D Vestibular neuritis affects the inferior vestibular nerve (posterior canal and saccule); labyrinthitis affects the superior vestibular nerve only

Explanation

Vestibular neuritis (viral/HSV-1 reactivation) selectively inflames the vestibular nerve — presenting with acute-onset severe rotatory vertigo, nausea, and imbalance lasting days to weeks, but with NORMAL COCHLEAR FUNCTION (no hearing loss, no tinnitus). Labyrinthitis involves both the cochlear and vestibular labyrinth, causing vestibular symptoms PLUS sensorineural hearing loss and tinnitus. Suppurative labyrinthitis (complication of bacterial CSOM) causes profound permanent SNHL. Serous labyrinthitis from toxins produces variable hearing change. The cochlear/vestibular distinction is the fundamental clinical differentiator between these two conditions.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.