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Ear, Nose, and Throat Disorders

Balance Disorders

Nearly 90 million Americans - more than one-third of the population - report bouts of dizziness at some point in their lives. Of these, 76 million suffer from inner-ear disorders, which can be caused by whiplash, blows to the head, viral infections, high doses of certain antibiotics, strokes or degeneration of the inner ear's balance function, also known as the vestibular system, which often deteriorates with age.

Balance disorders significantly reduce the quality of life for those individuals affected. The brain receives signals from the eyes, muscles and joints and from the inner ear, which contains semicircular canals filled with moving fluid. Head movements stimulate the inner ear by moving the fluid through the canals, thus sending messages to the brain about the position of the head and the body. A slight malfunction in any of these systems could cause a problem.

For the majority, an inner ear disorder is the cause of unsteadiness, loss of balance, dizziness or that whirling sensation called "vertigo." When the inner ear sends the brain incorrect information, or conflicting signals, the person feels dizzy. The usual response to this sensation is to limit movement so as to minimize the rocking or spinning sensations. Other possible causes for problems with balance or dizziness are metabolic inner ear or nervous system disorders, which often respond well to prompt treatment.

Diagnosing balance disorders of the inner ear involves specialized tests. These include:

Electronystagmography The patient is put through a series of tests involving light and movement, and warm or cool water is placed in the ear canals. The tests determine whether there is a weakness on one side or the other and identifies where the weakness is.

Moving Platform Posturography The balance system is made up of sight, the vestibular system, and the way you feel or sense the world through your muscle and joints. Even the pressure of the ground on the soles of your feet gives you information about balance. The platform posturography looks at each individual system and tries to identify where the problem is.

In this test, the patient stands on a platform and the position of the platform is changed. The patient's head is also put into various positions. The patient's posture is measured with his eyes open and with his eyes closed in each position.

Evoked Potentials Patients are fitted with headphones and given a series of sounds, such as clicks. These sounds test the condition of the auditory system as well as the nerve conduction to the brain.

Treatment

Treatment may include medications that help with vertigo (the sense that things are revolving). Several common medications for vertigo are Bonine™, Dramamine™, Bucladin™ and Antivert™. Another possible treatment is alteration in diet, such as reducing salt intake (salt causes the body, including ears, to retain fluid). Other possibilities are physical therapy and/or surgery.

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Last Reviewed: Mar 31, 2006

David  L Steward, MD David L Steward, MD
Professor of Otolaryngology
College of Medicine
University of Cincinnati