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Dizziness or Vertigo Overview

Ear Services from ENTACC

Dizziness is a symptom that a vast number of people experience at least once in their lives. Because there are so many potential causes, it is helpful for the patient to characterize their symptoms. This may be a sense of light headedness or even a faint feeling, as if they are going to black out. Symptoms such as these are usually secondary to cardiovascular or neurological problems.

Another form of dizziness is vertigo which is also a symptom and not a diagnosis. This is a sense of abnormal movement in terms of one’s surroundings in space. It may be a feeling of spinning, rocking or sea sickness and may be accompanied by other symptoms such as nausea, vomiting, ringing in the ears, hearing loss or fullness of the ears. Vertigo is most frequently secondary to a dysfunction of the inner ear. Other forms of dizziness, such as light headedness, may be caused by neurological disorders, cardiovascular disease, metabolic disorders and/or side effects of medication.

The cochleovestibular nerve is the eighth cranial nerve and is responsible for two special senses, both hearing and balance. The hearing apparatus, or cochlea, transmits sound vibrations from the outer environment to the auditory or hearing nerve through the cochlea or spiral organ of the inner ear. The vestibular or balance apparatus is responsible for sensing position changes of the head and the response to gravity. These sensations are transmitted from the semicircular canals and other sensory apparatus of the inner ear to the vestibular nerve. As a result of the proximity of these two senses in the inner ear, hearing and balance disorders are frequently interconnected.

Examples of vestibular disorders include benign paroxysmal postural vertigo (BPPV), Meniere’s disease, acute labyrinthitis, medication toxicity to the vestibular system, acoustic neuromas (benign tumors of the vestibulocochlear nerve), etc. Vertigo may also be a manifestation of central nerve system problems, such as multiple sclerosis or vertebrobasilar insufficiency, migraines, brain tumors, Lyme’s disease and medications.

Patients who experience light headedness, dizziness or vertigo should carefully record their symptoms in terms of where and when they occur and what factors may tend to aggravate or lessen the symptoms. The vestibular system of the inner ear is the leading cause of vertigo but still accounts for less than 50 percent of the causes.

Otolaryngologists evaluate vertigo initially by performing a thorough history and physical examination. Audiometric (hearing) testing is usually a part of the initial evaluation. After additional studies of the inner ear balance and hearing mechanism, such as a VNG
(videonystagmography) and ABR (auditory brain stem response test), various blood tests and X-ray studies may be ordered. If these studies indicate that the problem is a vestibular disorder, then the otolaryngologist will direct medical, surgical and other treatment options that are available. This may include head repositioning maneuvers, vestibular rehabilitation, surgery to decompress the pressure of the inner ear, or medications to lower the pressure of the inner ear or suppress the inner ear to control the patient’s symptoms of disequilibrium.

The health care providers of ENTACC have available to them a highly trained Audiological Department which can perform all of the testing described above. The full complement of medical, repositioning and surgical treatment options are available and can be directed by our ENT physicians.

Erin O. from Downingtown, PA

“I had stopped taking my allergy medicine and ended up with the worse sinus infection of my life. The staff at Ear, Nose & Throat Associates of Chester County genuinely will provide you with the best care. I was overwhelmed by the kindness, concern, and sense of urgency everyone gave. My phone calls were returned promptly and time was made to see me in the office when it was an emergency.”

Connie J. from West Chester, PA

“I can say after years of coming to Ear, Nose & Throat Associates of Chester County, my relationship and trust with Dr. Marriotti has grown tremendously. He is personable, friendly and I appreciate his input with my hearing condition. The staff at Ear, Nose & Throat Associates of Chester County is always cheery and pleasant. I enjoy my visits and always leave feeling like I am in good hands.”

Dauna P. from University Lincoln, PA

“I am so grateful for the care Dr. Picariello has given for my complex and serious brain diagnosis. He has made such an impression on the way the process was handled. I shall never forget him and how humble he was when dealing with my condition. He is truly one of the best around and I am fortunate for his high ethical standards and professionalism.”

Kathy S. from Schwenksvile, PA

“The knowledge, encouragement, concern, and individual attention the doctors of Ear, Nose & Throat Associates of Chester County had demonstrated was far beyond my expectations. The office atmosphere is professional yet friendly. The doctors know their profession well and are able to explain in basic understandable terms. They made sure we were comfortable and took their time going over everything extensively.”

James B., from Coatesville, PA

“The allergy shot process has been a great experience and has prevented a reoccurrence of my nasal polyps, and decreased the need for my asthma inhaler. The allergy staff is excellent.”