Dizziness & Vertigo
A common phrase for the sensation of being off balance is dizziness. Vertigo is the term used to describe the unfounded feeling that the room is spinning or moving. The inner ear might be the source of either sensation. Three semicircular balance canals and the saccule and utricle, two vestibular organs, are located in the inner ear, which is an essential part of the body’s balance system. The inner ear, the eyes, proprioception and sensory neural pathways, and the brain all function together as one large, intricate neural signaling network.
A trip to an ear, nose, and throat specialist can assist in identifying the reason and potential treatments for vertigo or dizziness. You might be referred to other experts, such as neurologists or cardiologists, because not all causes of dizziness come from the inner ear.
Benign Paroxysmal Positional Vertigo (BPPV)
Inner ear problems can lead to dizziness for a variety of reasons, including:
Brief episodes of spinning vertigo brought on by head position are a feature of benign paroxysmal positional vertigo. Calcium crystals (canaliths) in the semicircular balance canals dislocate, which is what causes it. The Epley technique, a sequence of head adjustments intended to realign the calcium crystals in the balance canals, can be used to treat this problem in the office.
Tinnitus, ear fullness, episodic vertigo bouts lasting minutes to hours, variable low-frequency sensorineural hearing loss…these symptoms are typical of Meniere’s illness. Endolymphatic hydrops, a buildup of fluid pressure inside the inner ear, is what causes it. A low-sodium diet and diuretics are typically used as treatment, although in more serious situations, surgery may be necessary.
When the inner ear is infected with bacteria or viruses, labyrinthitis/vestibular neuronitis results. Typically, very severe vertigo might linger for days. Many patients first go to the emergency room because they are worried about having a stroke or being dehydrated. The underlying infection must be treated as well as supportive measures like hydration and anti-nausea medicines. To hasten recuperation, anti-inflammatory steroids may also be taken.
Semicircular Canal Dehiscence
A condition called semicircular canal dehiscence has just recently been diagnosed. As a result of hearing loss, hyperacusis (sensitivity to loud noises), tinnitus, and vertigo attacks brought on by pressure changes or loud noise, it entails degradation of the bony covering of the semicircular balancing canal. Some patients claim to be able to hear their bodily sounds, including their eye movements. For the diagnosis of this condition, a CT scan is typically required. If symptoms are severe, the dehiscence can be surgically corrected.
A perilymphatic fistula is a tiny tear in the membranes covering the oval or round windows that allow inner ear fluid to escape into the middle ear airspace. Tinnitus is one of the symptoms, along with acute hearing loss, dizziness, and nausea. Usually, there is a triggering event, such as a significant pressure change, a head injury, or prior ear surgery. Although uncommon, spontaneous fistulas can develop.
Typically, conductive hearing loss in one or both ears is brought on by otosclerosis. It is an issue with the bone otic capsule, which covers the inner ear. In most instances, the stapes bone becomes fixed in place by bony remodeling and breakdown of this bone. Dizziness that is typically described as feeling off balance can occur in severe situations when it affects the bone surrounding the cochlea or the balance canals. In some cases, surgical treatment can be used to address the conductive hearing loss brought on by otosclerosis.
Another typical cause of vertigo that does not come from the inner ear is migraine vertigo. Although episodes of vertigo that persist for hours are common with this illness, headaches may or may not be an aspect of it. Attacks are frequently started by motion or visual cues, as well as by aspects of one’s lifestyle like stress, food, dehydration, and alcohol use.
It can be difficult to diagnose dizziness and vertigo, thus a specialist’s evaluation is frequently recommended. A hearing test may be required as part of your examination, and after you meet the doctor, additional imaging or balancing tests may be required.