Complete Care for Inner Ear Disorders
There are several types of inner ear balance disorders that can cause problems with vertigo and hearing loss to one or both of your ears. University of Chicago Medicine otolaryngologists and audiologists can help diagnose and treat your the full scope of vestibular diseases. Common inner ear balance disorders include:
- Benign paroxysmal positional vertigo (BPPV), also known as positional vertigo, is a dizzy or spinning sensation in your head, and is the most common type of vertigo.
- Meniere's disease causes episodes of vertigo, ringing in the ears (tinnitus), ear pressure/fullness and hearing loss.
- Labyrinthitis and vestibular neuritis occurs when the hearing and balance nerves become inflamed, resulting in sudden hearing loss, balance problems and vertigo.
- Superior semicircular canal dehiscence (SSCD) is a rare condition where a patient has a loss or absence of the bone that covers your superior semicircular canal. With SSCD, you may have a variety of unusual symptoms, such as pressure- or sound-induced vertigo, hearing loss, ear pressure, or even hearing your own breathing and blinking.
Diagnosing Inner Ear Balance (Vestibular) Disorders
When diagnosing vestibular disorders, our audiologists may perform a videonystagmography (VNG), electrocochleography (ECoG) and/or vestibular-evoked myogenic potentials (VEMPs) to determine the functionality of your inner ear balance system.
Vestibular Evaluations
Vestibular testing is performed if you are experiencing dizziness, vertigo or imbalance. Depending on your symptoms, we may do several different tests during your visit to determine how well your vestibular system is working. Some of these tests are irritating and may temporarily exacerbate your symptoms of dizziness/vertigo, so we recommend you have a friend or family member accompany you to your appointment and help get you home afterward.
Computerized Dynamic Posturagraphy
Computerized dynamic posturography is used to objectively quantify and differentiate among three sensory inputs; the vestibular (inner ear system), somatosenory (feet, ankles, joints) and vision (eyes). When all three sensory inputs are working together, you will have proper balance. When one or more of the senses are not cooperating, you will experience imbalance or dizziness.
Computerized dynamic posturography cannot diagnose the source of your dizziness on its own, but it can be used in conjunction with other clinical test to help localize and categorize the sensory system or systems causing your dizziness or balance.
During a computerized dynamic posturography, you will be standing on a platform while wearing a safety harness, and you will remove your shoes so you have full access to the somatosensory input from your feet. We will administer a series of tests to measure how well you can maintain your balance under different conditions.
Videonystagmography (VNG)
During VNG testing, you will be wearing video goggles to record your eye movements. In part one, you will be asked to follow moving dots on the wall with your eyes. The second part involves moving your head and body into different positions, and in the last part, we test your caloric reflex. In part three we will put cool and warm air into the ear canal for one minute and measure the resulting nystagmus or eye movements. It is normal to feel dizzy during this test, but this feeling should subsides quickly.
Vestibular Evoked Myogenic Potential (VEMP)
For VEMP testing, electrodes will be placed on your forehead, under your eyes, along the sides of your neck and on your clavicle. Once those are secured, headphones will be inserted into your ear canal and a loud clicking noise is play in one ear while you look up or turn and look over your shoulder.
Video Head Impulse Testing (vHIT)
If you are having vHIT testing, you will wear special goggles to track your eye movements. You will be asked to focus on a target in front of you and the audiologist will make sudden movements of your head in certain directions to stimulate the various balance canals of your inner ear.
Treatment for Inner Ear Disorders
Our expert team collaborates with other University of Chicago Medicine and community-based specialists in neurology, psychiatry, physical therapy and occupational therapy so that, together, we can provide our patients with high-quality care and improved outcomes.
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Ear infections may be more common in children than in adults, but adults are still susceptible to these infections. Unlike childhood ear infections, which are often minor and pass quickly, adult ear infections can sometimes signal a more serious health problem.
If you’re an adult with an ear infection, it’s a good idea to pay close attention to your symptoms and talk with your doctor.
There are three main types of ear infections. They correspond to the three main parts of the ear: inner, middle, and outer.
Inner ear infection
A condition diagnosed as an inner ear infection may actually be a case of inflammation and not an actual infection. In addition to ear pain, symptoms include:
- dizziness
- nausea
- vomiting
- vertigo
- sudden hearing loss
Rarely, inner ear trouble may be a sign of a more serious condition, such as meningitis.
Middle ear infection
The middle ear is the area right behind your eardrum.
A middle ear infection is also known as otitis media. It’s caused by fluid trapped behind the eardrum, which causes the eardrum to bulge. Along with an earache, you may sense fullness in your ear.
Otitis media can come with a fever. You may also have trouble hearing until the infection starts to clear.
If you experience fluid draining from your ear, it could be a sign the middle ear infection has progressed to a tympanic membrane rupture. This condition can cause a sudden loss of hearing, but tends to heal on its own.
Outer ear infection
The outer ear is that part of your ear that extends out from your eardrum to the ear opening.
An outer ear infection is also known as otitis externa. An outer ear infection often starts as an itchy rash. The ear may become:
- painful
- tender
- red
- swollen
Ear infections can be caused by bacterial, viral, or fungal infections. But whether you get an outer or middle ear infection depends on how you become infected.
Middle ear infection
A middle ear infection often starts from a cold or other respiratory problem. The infection moves to one or both ears through the eustachian tubes. These tubes regulate air pressure inside your ear. They connect to the back of your nose and throat.
An infection can irritate the eustachian tubes and cause them to swell. Swelling can prevent them from draining properly. When fluid inside these tubes can’t drain, it builds up against the eardrum.
Outer ear infection
An outer ear infection is sometimes called swimmer’s ear. That’s because it often starts as a result of water that remains in the ear after swimming or bathing. The moisture becomes a breeding ground for bacteria.
If your outer ear is scratched or if you irritate the outer lining of your ear by putting your fingers or other objects in your ear, a bacterial infection can occur.
One of the reasons children are more likely than adults to get ear infections is that their eustachian tubes are smaller and more horizontal than the tubes in most adults. If you have small eustachian tubes or you have tubes that haven’t developed more of a slope, you’re at a higher risk for developing an ear infection.
You may also be more likely to get an ear infection if you smoke or are around a lot of secondhand smoke.
Having seasonal allergies or year-round allergies also puts you at risk.
Developing a cold or an upper respiratory infection also increases your risk.
If your only symptom is an earache, you may want to wait a day or two before seeing a doctor. Sometimes, ear infections resolve on their own within a few days. If the pain isn’t getting better and you’re running a fever, you should see a doctor as soon as you can.
If fluid is draining from your ear or you’re having trouble hearing, you should also seek immediate medical attention.
During your appointment, your doctor will get your medical history and symptoms. They’ll also use an otoscope to get a detailed look at your outer ear and your eardrum.
An otoscope is a handheld device with a light and magnifying lens that doctors use to check the health of your ear. A pneumatic otoscope can emit a puff of air in the ear.
When air is pushed against the eardrum, the way the eardrum reacts can help diagnose the problem. If the eardrum moves easily, you may not have a middle ear infection, or it may not be serious.
If it does not move easily, it could mean there’s fluid or pus involved, but not all fluid in the ear means an infection is present.
Another test used to diagnose and evaluate a possible ear infection is called tympanometry. It’s used to evaluate eardrum movement.
A simple hearing test may also be done, especially if it appears that an infection has caused some hearing loss.
The type of ear infection you have will determine the type of treatment. In many cases of middle and outer ear infections, antibiotics are necessary.
Treating middle ear infections
You may be prescribed antibiotics. Some antibiotics may be taken orally. Others can be applied directly to the site of the infection with ear drops. Medications for pain, such as over-the-counter pain relievers and anti-inflammatory medications may also be used to manage your symptoms.
If you’re still experiencing cold or allergy symptoms, you may be advised to take a decongestant, nasal steroids, or an antihistamine.
Another helpful technique is called autoinsufflation. It’s meant to help clear your eustachian tubes. You do this by squeezing your nose, closing your mouth, and gently exhaling. This can send air through the eustachian tubes to help drain them.
Treating outer ear infections
The outer ear should be carefully cleaned. That should be followed by the application of antimicrobial and anti-inflammatory medications on your ear.
Antibiotics may be prescribed if your doctor determines that the infection is bacterial.
If the infection is fungal, your doctor may prescribe an antifungal medication.
If you have a viral infection, you may simply need to tend to the irritation on your ear and wait for the infection to resolve itself. Depending on the type of virus involved, more specialized treatment may be necessary.
To help prevent an ear infection of any kind, follow these tips:
- Make sure you dry your ears completely after swimming or taking a shower.
- Try quitting smoking, and limit or avoid secondhand smoke when possible.
- Manage your allergies by avoiding triggers and keeping up with allergy medications.
- Wash your hands thoroughly, and try to limit contact with people who have colds or other upper respiratory problems.
- Make sure your vaccines are up to date.
While ear infections in adults are not as common as they are in children, they can still happen. If you suspect you may have an ear infection, it’s important to have it checked out by a doctor.
If an ear infection goes on too long without treatment, it can put an individual at risk of permanent hearing loss and possibly having the infection spread to other parts of the head. However, prompt and proper treatment can usually take care of the infection quickly.