Labyrinthitis is a general term for inflammatory diseases that occur on the lips. There are acute labyrinthitis and chronic labyrinthitis according to the course of the disease; vesicular labyrinthitis, eczematous labyrinthitis, and desquamative labyrinthitis according to the characteristics of clinical symptoms; chronic nonspecific labyrinthitis, glandular labyrinthitis, benign lymphoproliferative labyrinthitis, granulomatous labyrinthitis, May-Lo syndrome, photochemical labyrinthitis, and allergic labyrinthitis according to the etiopathology.
I. Etiology of labyrinthitis
1.Chronic non-specific labyrinthitis
The etiology is unknown and may be related to certain temperature, chemical, and mechanical long-term continuous irritants. For example, addiction to alcohol, tobacco, hot food; lip licking and lip biting bad habits. Related to mental factors.
2.Adenoidal labyrinthitis
The cause is not known. There is the possibility of autosomal dominant inheritance. Possible acquired factors include the use of toothpaste or mouthwash with allergenic substances, trauma, smoking, poor oral hygiene, emotions, etc. It is thought that this disease is a manifestation of Crohn’s disease.
3. Benign lymphoid hyperplastic labyrinthitis
The etiology is unknown. It may be related to the proliferation of primitive lymphoid tissue remaining during embryonic development in response to light radiation.
4.Plasmacytic labyrinthitis
The etiology is unknown. It may be related to local peripheral circulation disorders, endocrine disorders, diabetes mellitus, hypertension and other diseases; local long-term mechanical stimulation such as denture stimulation, or light stimulation may also be the cause of this disease.
5. Granulomatous labyrinthitis
The etiology is unknown. It may be related to bacterial or viral infections, allergic reactions, vasodilatory disorders, genetic factors, etc.
6.May-Ro syndrome
The etiology is unknown. Genetic factors, infectious factors, allergic factors, vasodilatory disorders may be related to this disease.
7.Photochemical labyrinthitis
Photic labyrinthitis is a lip infection caused by excessive sunlight exposure, which is caused by allergy to ultraviolet light in sunlight.
8.Allergic labyrinthitis
Allergic labyrinthitis is a lip infection caused by exposure to allergens. Certain foods, drugs, infectious factors, mental factors, physical factors, etc. can be triggering factors for this disease.
Second, the treatment and prevention of labyrinthitis
1. Chronic non-specific labyrinthitis
The cause of the disease may be related to temperature, chemical and mechanical chronic and continuous stimulation factors, such as: cold plateau or dry climate areas, addiction to alcohol and tobacco, bad habits of lip licking and lip biting, and habits of eating spicy and hot food. Chronic non-specific labyrinthitis is characterized by dry flaking of the affected lips, itching and burning, oozing and crusting, mostly in the red part of the lower lip, and repeated infections can appear as pus crusts covering the chapped area, with deeper chaps, severe pain and swelling that does not subside. Treatment: local wet compress with 1:5000 compound furacilin solution, then topical application of gentamycin eye ointment or skin fluoxone ointment, the effect is not obvious feasible local injection of tretinoin treatment. Prevention: avoid stimulation, quit smoking and alcohol, avoid spicy food.
2. Adenoid labyrinthitis
The cause is not clear, but may be related to congenital heredity, gingivitis, periodontitis and other local lesions and local stimulation. Prevalent in middle-aged or middle-aged men, mostly in the lower lip, suffering from lip gland hyperplasia hypertrophy; secondary infection, there is purulent discharge, lip swelling and pain is obvious, a few patients who do not heal repeatedly for a long time can become cancerous. Treatment: 10% potassium iodide can be taken orally, topical application of gentamycin eye ointment or fluorine easy ointment; or local injection of prednisone suspension.
3.Benign lymphoproliferative labyrinthitis
The cause of the disease may be related to the proliferation of the original lymphoid tissue remaining during embryonic development under light radiation. It is mostly found in the red part of the lower lip of young and strong women, and is characterized by a yellowish scab-covered local area with paroxysmal intense itching, which occurs about 1-2 times a day, and the itching is gradually relieved after the scab falls off and the yellowish liquid flows out. Treatment: The disease is sensitive to radiation and can be treated with radiotherapy. Prevention: Avoid sun exposure.
4. Granulomatous labyrinthitis
The etiology of this disease is unknown. It may be a specific reaction to Crohn’s disease, periapical inflammation, lipofuscinosis, or a foreign body reaction to subcutaneous fat degeneration. It presents as a diffuse swelling of the patient’s lip, which is hypertrophic, firm and elastic, without pain on compression or edema-type depressions. The upper lip is more affected than the lower lip, and there are cases where both upper and lower lips are involved. The swelling can subside at the beginning, but repeatedly the swelling does not subside, and the skin of the swollen area is light red, turning dark red after repeated episodes, and the upper lip is swollen and outwardly curved. Treatment: local injection with tretinoin.
5.Mei-Luo syndrome
Also known as granulomatous labyrinthitis syndrome or triad of lip swelling, facial palsy and cleft tongue. The etiology is unknown. It manifests as diffuse swelling and thickening of the lip, which can occur simultaneously with peripheral facial nerve palsy and cleft tongue or with map tongue. However, when only any two of the above signs are present, it can also be called incomplete syndrome. Treatment: Local injection of prednisolone suspension.
6.Photochemical labyrinthitis
Acute inflammatory reaction caused by strong and excessive sunlight exposure (including ultraviolet light, X first, strong light source, etc.). The disease occurs in summer and can be divided into 2 types of acute and chronic onset. Acute actinic labyrinthitis, also known as cicatricial labyrinthitis, is characterized by edema and congestion of the patient’s lips, blisters, erosion, crusting, and rapid onset. It is common to have an attack on the same day after exposure to the sun, with significant burning and intense itching. Chronic actinic labyrinthitis, also known as desquamative labyrinthitis, has obvious dryness and discomfort, with recurrent episodes of labyrinthitis, thickening of the lip mucosa, dryness and cracking, and epithelium covered with white chaffy scales. Treatment: In the acute stage, wet compresses are applied, and hormone or antibiotic ointment can be applied when there is no exudate. Prevention: avoid sun exposure.
7.Pathogenic lip infection
The cause of the disease is lip inflammation caused by contact with allergens. When the antigen enters the body for the second time, it can stimulate type I metaplasia, resulting in the release of histamine slow-reacting substances, causing mucosal capillaries, increased permeability of the tubular wall, resulting in tissue edema; contact labyrinthitis occurs after type IV metaplasia due to direct contact with allergens in the red part of the lips, such as cosmetics, certain drugs, etc. The disease is divided into 2 types: acute and chronic. Acute is lip angioneurotic edema, which is characterized by diffuse swelling of the upper lip with unclear perimeters and can spread to the nose and cheek area, sometimes accompanied by swelling of the tongue and throat, which can cause respiratory distress and even asphyxia. Chronic is similar to the above-mentioned lip symptoms, without other areas outside the lip with accompanying swelling. Treatment: Apply corticosteroids and antihistamines for treatment. Prevention: Avoid contact allergens.
Lip infection not only brings great pain and inconvenience to the patient’s life and work, but more seriously, untreated will directly affect the immune function of the patient’s entire body, triggering systemic symptoms such as oral and neurological lesions, and even causing malignant changes that endanger life, so timely treatment is the key.