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Otolaryngology

Benign Paroxysmal Positional Vertigo (BPPV)

The most common inner ear problem associated with dizziness is Benign Paroxysmal Positional Vertigo (BPPV).  Symptoms associated with BPPV include a brief burst of spinning dizziness (less than 1 minute) associated with head movements such as looking up, looking down, rolling over and/or bending over. This is a not life threatening condition and is the easiest form of dizziness to treat. 

BPPV occurs when canaliths (crystals/ear rocks) that are attached at the base of the semicircular canals of the inner ear become dislodged and free float in the canals.  This causes the patient to experience a burst of dizziness when they move their head in certain directions.  The symptoms of BPPV include a delayed onset of dizziness (several seconds); response may fatigue throughout the day and typically lasts less than 1 minute. In most cases the cause of BPPV is unknown, but some causes may include head trauma, other inner ear problems and aging.

The treatment that is recommended for BPPV is called an Epley Maneuver or Canalith Repositioning Procedure.  Through a series of head and body movements the audiologist is able to reposition the canaliths into the area of the inner ear where they belong.  This maneuver is typically 85 percent effective, but in many cases may need to be repeated. To keep the canaliths in place following the procedure there will be instructions that need to be followed.  If symptoms continue following several maneuvers, then it may be recommended that a patient have a test called an Electronystagmography (ENG), to rule out any other inner ear problems that may be present.

Vestibular rehabilitation therapy is another treatment that may be recommended for other forms of inner ear disorders.  Vestibular rehabilitation requires the patient to perform habituation, adaptation, gait and balance exercises to help the balance system function more normally.  Many patients have shown improvement in their daily functional activities following vestibular rehabilitation therapy for their dizziness.  Vestibular rehabilitation therapy is typically performed by a physical therapist.

There are many conditions concerned with hearing that require clinical care by a physician or other healthcare professional. Listed in the directory below are some of the conditions, for which we have provided a brief overview.

If you cannot find the condition in which you are interested, please visit the Otolaryngology Online Resources page in this Web site for an Internet/World Wide Web address that may contain additional information on that topic.

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