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Hearing & Balance Doctors is currently open. We are taking special measures to prevent the spread of COVID-19 including offering a curbside service for hearing aids. Please call 435-688-8991 for more information. Utah: 435-688-8991 | Nevada: 702-896-0031
Hearing & Balance Doctors is currently open. We are taking special measures to prevent the spread of COVID-19 including offering a curbside service for hearing aids. Please call 435-688-8991 for more information. Utah: 435-688-8991 | Nevada: 702-896-0031

Balance Evaluations

The inner ear has two main functions: to help us hear and to help us maintain our balance. The part of our inner ear that helps us to hear is shaped like a snail shell and is called the cochlea. The part of our inner ear that helps us maintain our balance is a series of loops and canals and is called the vestibular system. Our clinic, Hearing & Balance Doctors, specializes in the diagnosis and treatment of both hearing and balance disorders.

Balance And The Inner Ear

Balance And The Inner Ear

The inner ear lies deep within the temporal bone of the skull. It lies far beyond the eardrum and is just centimeters away from the brainstem. As mentioned above, the balance system of our inner ear is known as the vestibular system. The vestibular system includes three sets of semicircular canals and two sacs (the utricle and saccule). Inside the utricle and saccule lie small crystals – known as otoliths – that help us detect linear motion.

The entire inner ear is full of fluid and acts like a gyroscope to detect motion. A nerve attached to the inner ear, the vestibulocochlear nerve, sends signals to the brain letting us know how we are oriented in space. If any part of this system is not working properly (the otoliths, the nerve, the semicircular canals, etc.) the result is often dizziness or vertigo.

Balance Testing By Doctors Of Audiology

The doctors of audiology at our clinic all specialize in diagnosing inner ear-related balance issues. Before a balance evaluation (also called videonystagmography testing) our doctors will take a thorough case history. The patient will be asked to describe the onset, severity, and duration of symptoms. A general medical history, including a list of medications, will also be conducted. There are several tests that may make up a comprehensive balance test. They include:

  • An audiologic evaluation (hearing test) – This helps the doctor rule out certain inner ear issues that may affect hearing as well as cause dizziness.
  • Tympanometry – This test of eardrum mobility can help the doctor rule out fluid behind the eardrum (often associated with allergies or infections) as a potential cause of dizziness.
  • Computerized dynamic posturography – This test is taken with the patient securely strapped into a safety harness while standing on a moving platform and surrounded by moving walls. The test helps to differentiate inner ear issues from somatosensory and vision issues.
  • Auditory brainstem response – This test involves electrodes being placed on the forehead and ears. A sound is played to the ear and the response of the brainstem is measured. This test can help rule out tumors (such as a vestibular schwannoma) as the source of dizziness and vertigo.
  • Vestibular evoked myogenic potential (VEMP test) – A VEMP test involves electrodes being placed on the forehead, neck, and sternum. A sound is played to the ear through an earphone and a response is recorded through the sternocleidomastoid muscle of the neck. This test helps to evaluate the function of the saccule as well as the inferior branch of the vestibular nerve.
  • Oculomotor tests – These tests are performed while the patient wears goggles with infrared cameras inside. The goggles and cameras allow our doctors to observe the motion of the eyeball. Our eyes and inner ears are connected via the vestibulo-ocular reflex. By observing the motion of the eye, our doctors can diagnose certain inner ear issues.
  • Positional tests (including the Dix Hallpike maneuver) – These tests help to rule out otoliths, or “crystals” loose in the semicircular canals.
  • Air caloric testing – This test involves blowing either cool or warm air into the ear canal. The temperature of the air transfers through the eardrum to the inner ear. When the temperature of the inner ear changes, the fluids that fill the inner ear begin to move. When the fluids in the inner ear move, an individual feels as if he or she is moving. This sense of motion is observable through the eyes and allows our doctors to evaluate the status of the inner ear. Air calorics are a very important test that helps our doctors diagnose inner ear issues such as vestibular neuronitis and labyrinthitis.

These tests, when performed together as part of a battery of tests, comprise a typical “balance test.” These tests allow our doctors of audiology to rule out the inner ear as the source of a balance issue.

Can Hearing Affect Your Balance?

Hearing problems can affect balance. Research has consistently shown that hearing problems can result in an increased risk of falls. This is simply due to a decrease in awareness of the environment. This lack of awareness can lead to stumbles and falls.

However, hearing problems typically do not cause dizziness or vertigo. There are some exceptions: Meniere’s Disease or labyrinthitis, for example, can cause both hearing loss and vertigo.

Have Your Balance Issues Addressed At Hearing & Balance Doctors

If you or a loved one is suffering from problems of dizziness, vertigo, balance, or hearing loss, schedule an appointment today. Our audiologists will be able to thoroughly evaluate your inner ears and create an appropriate treatment plan to help you achieve better balance.