Endoscopic Ear & Otology
Vertigo
Vertigo is a sensation where a person feels as if they or their surroundings are spinning or moving, even though they are actually stationary. It is often described as dizziness or a feeling of imbalance. This sensation can be unsettling and may be accompanied by symptoms such as nausea, vomiting, diarrhoea, sweating, and difficulty maintaining balance.
Vertigo typically arises from issues in the inner ear or problems with the vestibular system, which is responsible for maintaining balance and spatial orientation. Common causes of vertigo include:
Benign Paroxysmal Positional Vertigo (BPPV) - caused by tiny calcium particles (canaliths) becoming dislodged in the inner ear canals
Meniere's Disease - a disorder of the inner ear characterised by episodes of vertigo, hearing loss, tinnitus (ringing in the ear), and a feeling of fullness in the ear
Vestibular Neuritis - Inflammation of the vestibular nerve, often triggered by viral infections
Labyrinthitis - Inflammation of the inner ear labyrinth, typically due to infections
Other less common causes include head injuries, certain medications, migraines, and neurological conditions like multiple sclerosis.
Diagnosis & Treatment
Diagnosis of vertigo involves a thorough medical history, physical examination focusing on balance and eye movements, and sometimes specific tests such as vestibular function tests, audiograms, tuning fork tests and imaging studies (Xray, MRI or CT scans).
Treatment depends on the underlying cause but may include medications to alleviate symptoms (labyrinthine sedatives to calm the inner ear), vestibular rehabilitation exercises to improve balance (eg. Brandt-Daroff and Cawthorne-Cooksey exercises), and lifestyle modifications. In some cases, manoeuvres or procedures like the Epley manoeuvre (for BPPV), steroid or aminoglycoside injections into the inner ear may be recommended. Surgery is rarely needed, typically only in cases like acoustic neuroma.
