Balance – being able to stand, walk and generally move without falling – is controlled by the vestibular system. Most of that system is located deep in the inner ear and includes the vestibulocochlear nerve. That nerve sends messages to the brain about sound and your body’s position in the environment.

Because hearing and balance messages go through the same channel, problems processing these messages can lead to hearing and/or balance disorders. Trinity Health audiologists have a variety of methods to uncover the root of your symptoms and properly treat it.

Conditions We Assess

• Balance problems: Difficulty staying in an upright position.
• Balance Disorder: A condition where you feel unsteady or dizzy. It may include feelings of moving, spinning, or floating. When walking, you might have the sensation you are about to tip over.
• Vertigo: Technically a sensation, not a condition or disorder, vertigo is the illusion that you or your surroundings are spinning or moving when they are not.
• Ménière’s Disease: An inner ear disorder that causes dizziness, ringing in the ears and hearing loss.

Tests and Procedures

• ENG (Electronystagmography): Testing that uses a reflex between the inner ear and the eyes to measure function of the vestibular nerve and oculomotor nerve. Water is placed in the ear canals to activate the balance system on each side independently. This testing includes several positional tests of the body.
• VEMP (Vestibular Evoked Myogenic Potential): Testing that can be used in differential diagnosis or monitoring of certain conditions that cause vertigo. This includes using acoustic stimuli to measure an involuntary vestibular response.
• VNG (Videonystagmography): VNG is a group of tests that look for signs of vestibular dysfunction or neurological deficits by measuring nystagmus and other physiologic responses. The first VNG subtest evaluates the movement of the eyes as they follow specific targets. The second subtest observes eye movement as the head is positioned in different directions. And lastly, during the caloric test, warm and/or cold water or air is circulated in the ear canal to test the vestibular response stimulated by the temperature change.

Treatment and Referrals

Treatment for balance disorders is called vestibular rehabilitation. It is a specific kind of physical therapy to evaluate and improve visual-motor skills, balance, gait, strength, and coordination.

If your hearing and balance tests suggest another reason for symptoms of dizziness, etc., our team will refer you to the following Trinity Health providers as appropriate:

• ENT for conditions related to the inner ear and vestibular system.
• Neurology for symptoms that may be related to stroke or neurological disorders.
• Cardiology for symptoms stemming from blood pressure and circulatory issues.