Health Topic Archives

“Balance, Dizziness and the Inner Ear System” (Part 1 of 3)

Dr. Karen WoolawayHello, my name is Dr. Karen Woolaway. I am an audiologist who specializes in balance and dizziness as well as hearing loss and hearing aids. Today, I will be focusing on balance and dizziness and how the inner ear system relates to balance.

Balance disorders can affect anyone at any age, although the older you get, the more likely it is that you will experience some type of balance problem. The most common cause of dizziness or vertigo is benign proximal positional vertigo, or BPPV, which can be brought on by inflammation or a virus in the inner ear. It occurs when crystals, or otoliths, dislodge from a portion of the inner ear and interfere with the motion sensors in one or more of the three fluid-filled semi-circular canals. Keep in mind that each ear has three semi-circular canals. Typical effects are sudden dizziness when turning your head, rolling over in bed, looking up, or other head movements. The dizziness can last from seconds to hours. This condition may occur at any age, but by age 70, 50% of all individuals will have experienced BPPV.

Inner Ear

There is no pain, such as with an earache, but you may have initially experienced some vertigo and nausea lasting hours. Common medical conditions such as cardiovascular disease, diabetes, migraines, stroke and mild head trauma may also cause BPPV.

The most popular treatment for BPPV is a simple and painless repositioning maneuver. The treatment returns the otolith debris to the utricle allowing the body to absorb the calcium carbonate crystals in a few days.


Repositioning procedures are not a permanent cure, but a treatment. The condition may recur and oftentimes does anytime from a few months to years later or, if you are lucky, never. Other medical conditions and prescription medications may promote reoccurrence if they affect the body’s processing of calcium.

Why is it important to identify inner ear problems?

Inner ear problems often cause people to fall resulting in injury. Fallers tend to fall again. Most falls can be prevented if the patient receives therapy for an inner ear problem.

In one study, when patients were seen in the emergency room for “unexplained falls”, once evaluated, 80% of the patients had symptoms indicating that the inner ear was partially to blame. About 10 to 15% of falls are associated with serious injuries such as fractures. Repeat fallers who injure themselves tend to die within one year.

So how do you know if you have benign paroxysmal positional vertigo?

Symptoms are provoked with quick head movements and the actual dizziness symptoms last less than a minute and are triggered by rolling over in bed, looking up, or laying down at night. You may experience nausea or feeling off for a longer period. These symptoms may occur several times per day.

Some things to know about benign proximal positional vertigo.

BPPV does not respond to anti-motion medications such as Antivert, Meclizine, Valium, or patches. The good news is that there is a nonsurgical, not medication treatment that is successful 95% to 98% of the time, and it is a very gentle procedure. People often have a secondary inner ear problem in addition to BPPV, and vestibular rehabilitation can help or eliminate the symptoms. Patients are not told to learn to live with it.

If you or someone you know is suffering from imbalance and/or dizziness, give us a call. Our office requires a referral from your physician prior to scheduling an appointment.

Woolaway Audiology, PLLC
Dr. Karen Woolaway, Audiologist
84 Canal Street, Suite 8,
Minier’s Plaza, Big Flats, NY 14814
(607) 301-4144

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