Our physicians and audiologists are uniquely qualified to diagnose and treat hearing loss, dizziness and balance disorders. We offer the most advanced diagnostic testing and treatment options available.
- You may hear but not understand people
- You may have difficulty understanding radio, television or public address systems
- You need to watch a person’s lips in order to understand
- You find yourself asking people to repeat what they have said
- You may pretend to understand
- You may avoid people and isolate yourself
- You may find it emotionally and physically exhausting to communicate
- It appears that you are the only one who has these difficulties
Examples of conditions that may cause a conductive hearing loss include:
- Conditions associated with middle ear pathology such as fluid in the middle ear from colds, allergies (serous otitis media), poor eustachian tube function, ear infection (otitis media), perforated eardrum, benign tumors
- Impacted earwax (cerumen)
- Infection in the ear canal (external otitis)
- Presence of a foreign body
- Absence or malformation of the outer ear, ear canal or middle ear
Sensorineural hearing loss not only involves a reduction in sound level, or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly.
Sensorineural hearing loss can be caused by diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes. Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma, aging and tumors.
Other descriptors associated with hearing loss are:
- Bilateral versus unilateral. Bilateral hearing loss means both ears are affected. Unilateral hearing loss means only one ear is affected.
- Symmetrical versus asymmetrical. Symmetrical hearing loss means that the degree and configuration of hearing loss are the same in each ear. An asymmetrical hearing loss is one in which the degree and/or configuration of the loss is different for each ear.
- Progressive versus sudden hearing loss. Progressive hearing loss is a hearing loss that becomes increasingly worse over time. A sudden hearing loss is one that has an acute or rapid onset and therefore occurs quickly, requiring immediate medical attention to determine its cause and treatment.
- Fluctuating versus stable hearing loss. Some hearing losses change—sometimes getting better, sometimes getting worse. Fluctuating hearing loss is typically a symptom of conductive hearing loss caused by ear infection and middle ear fluid, but also presents in other conditions such as Meniere's disease.
- A sensation of dizziness or vertigo (spinning)
- Falling or a feeling of falling
- Lightheadedness or feeling woozy
- Visual blurring
Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period of time.
- Peripheral vestibular disorder, a disturbance in the labyrinth
- Central vestibular disorder, a problem in the brain or its connecting nerves
- Systemic disorder, a problem of the body other than the head and brain
- Vascular disorder, or blood flow problems
Benign Paroxysmal Positional Vertigo (BPPV) – a brief, intense sensation of vertigo that occurs because of a specific positional change of the head. An individual may experience BPPV when rolling over to the left or right upon getting out of bed in the morning, or when looking up for an object on a high shelf. The cause of BPPV is not known, although it may be caused by an inner ear infection, head injury or aging.
Labyrinthitis – an infection or inflammation of the inner ear causing dizziness and loss of balance.
Ménière's disease – an inner ear fluid balance disorder that causes episodes of vertigo, fluctuating hearing loss, tinnitus (a ringing or roaring in the ears), and the sensation of fullness in the ear. The cause of Ménière's disease is unknown.
Vestibular neuronitis – an infection of the vestibular nerve, generally viral.
Perilymph fistula – a leakage of inner ear fluid to the middle ear. It can occur after head injury, physical exertion or, rarely, without a known cause.
Some examples of diagnostic tests your physician may request are a hearing examination, blood tests, audiology tests including a videonystagmogram (VNG), vestibular evoked myogenic potential (VEMP), electrochleography and/or imaging studies of the head and brain.
VNG testing is used to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem, and is one of the only tests available today that can distinguish between a unilateral (one ear) and bilateral (both ears) vestibular loss. VNG testing is a series of tests designed to document a person’s ability to follow visual objects with their eyes and how well the eyes respond to information from the vestibular system. To monitor the movements of the eyes, infrared goggles are placed around the eyes to record eye movements during testing. VNG testing is non-invasive, and only minor discomfort is felt by the patients during testing as a result of wearing goggles. A caloric test may be performed as part of the VNG, in which each ear is irrigated with warm and then cool air, usually one ear at a time; the amount of nystagmus resulting is measured. Weak nystagmus or the absence of nystagmus may indicate an inner ear disorder.
The Vestibular Evoked Myogenic Potential test is recognized as an important tool in the routine vestibular test battery. Whereas traditional ENG/VNG test batteries may be used to assess the semicircular canals, the VEMP test is specifically for assessing the Saccule and associated Inferior Vestibular Nerve function, which may assist in explaining the cause for your dizziness and/or balance disorder.
An additional procedure to assist in obtaining a diagnosis is an electrochleography. An electrochleography is an inner ear test involving the use of sound stimulation to provide electrical measurements which can be used to assist in the diagnosis of Méniére's disease.
Another treatment option includes balance retraining exercises (vestibular rehabilitation). The exercises include movements of the head and body specifically developed for the patient. This form of therapy is thought to promote compensation for the disorder. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body.
For people diagnosed with Ménière's disease, dietary changes such as reducing intake of sodium may help. For some people, reducing alcohol, caffeine, and/or avoiding nicotine may be helpful. Some aminoglycoside antibiotics, such as gentamicin and streptomycin, are used to treat Ménière's disease. Systemic streptomycin (given by injection) and topical gentamicin (given directly to the inner ear) are useful for their ability to affect the hair cells of the balance system. Gentamicin also can affect the hair cells of the cochlea, though, and cause hearing loss. In cases that do not respond to medical management, surgery may be indicated.
For additional information, please do not hesitate to ask your physician or audiologist.