Testing for inner ear problems starts with a hearing test.  Based on the audiogram results, the speech understanding score, and the level at which sounds become uncomfortable, information is obtained that can help pinpoint the origin of the symptoms.   In addition to the hearing test, middle ear and acoustic reflex testing can give information about the integrity of the auditory nerve.  These are the basic diagnostic tools.  More specialized testing may be warranted, based on the preliminary test results.

Common Conditions of the Inner Ear

Common conditions of the inner ear are Labyrinthis, Meniere’s Disease, and Benign Paroxysmal Positional Vertigo (BPPV).   A general description of these conditions are as follows:

• Labyrinthitis is inflammation of the inner ear membrane.  It can be caused by either bacterial or viral infections.  Labyrinthitis often occurs as a result of an upper respiratory infection or an acute ear infection.  Meningitis can also lead to labyrinthitis. The symptoms are hearing loss, vertigo, tinnitus, and nausea.   Symptoms last for several weeks.  Treatments are typically as follows: Antibiotics for bacterial infections; steroids and antiviral medications for viral infections; and medications that ease the vertigo.
• Meniere’s Disease is a condition in which excess inner ear fluid builds up to a point that it damages the membranes within the inner ear, causing a shutdown of communication from the ear to the brain.  Symptoms of Meniere’s are sudden attacks of vertigo, nausea, hearing loss, distorted sound quality, hypersensitivity to sounds, and a roaring tinnitus.  These symptoms last a few days, during which time the structures heal.  Reoccurrence of attacks is expected.  Over time, permanent hearing loss and balance problems will linger.  The cause of Meniere’s is unclear.  It can be caused by allergies, head injury, smoking, chronic ear infections, labyrinthitis, narrowing of the canals, autoimmune disorder, a high sodium diet, or excessive alcohol consumption.  Treatments include diuretics, low-sodium diet, antivertigo medications, and steroids.  Attention to other health issues such as allergies, anxiety and stress, high cholesterol, and high blood pressure may be warranted.
• BPPV (Benign Paroxysmal Positional Vertigo) is a condition where loose calcium carbonate crystals in one of the semicircular canals are floating free.  These crystals are supposed to be there but should be imbedded in place.  Occasionally a few will come loose and cause a drag effect on the fluids in that particular canal.  The drag causes the sensory cells in that canal to be stimulated much more strongly than the other ear.  The information sent to the brain regarding movement is dramatically different between the two ears and the conflict causes sudden, intense vertigo.  The vertigo occurs only when in certain body positions, usually when laying down and turning to a particular side, and often when looking up (e.g to see under the sink, look into a high cabinet). Relief comes quickly by changing body positions.  Causes can be allergies, head injury, long-term illness, or long-term bed rest.  Often the cause is unknown. Treatment for BPPV is simple.  Sometimes it resolves on it’s own.  Usually it requires an office visit for treatment by physically maneuvering the head to release the particles from the canal. This is called an Epley maneuver.  The maneuver takes just a few minutes and is painless.  There are no lasting effects from BPPV, although reoccurrence is common in many cases.  Home exercises can also be effective treatment.  BPPV does not affect hearing.  Diagnosis and treatment of BPPV can be done at Texas Sinus Center.

A note of caution: Dizziness and Vertigo, even a feeling of being slightly off balance, can be a sign of a more serious condition such as a tumor.  Please seek medical attention by an Ear, Nose and Throat physician or an *Otologist, doctors who have specialized in the ear, if you have any of the symptoms mentioned above.