Here are the most common causes of balance problems and how they are treated:
An acoustic neuroma, also called a vestibular schwannoma, is a benign growth of the balance nerve. They grow in a part of the skull between the brain and the ear. If they continue to grow, they can cause hearing loss and dizziness. Large acoustic neuromas are life threatening because they can push on a core part of the brain. There are three means of treating acoustic neuromas. One method is not to treat the tumor and follow its progression with regular MRI scans once or twice per year. Less than half of acoustic neuromas grow, and if the tumor is not growing it may be able to be left alone if it is not causing problems with dizziness. This is usually not recommended for very large tumors. Another treatment for acoustic neuromas is focused radiation therapy. While radiation does not make the tumor go away, it may be able to slow its growth. After radiation therapy, regular MRI scans are required indefinitely to make sure the tumor doesn't’t grow further. A third treatment option for acoustic neuromas is microsurgery. Microsurgery requires the expertise of both a neurotologist like Dr. Eisen and a neurosurgeon, but results in tumor removal with little chance of the tumor returning. Depending on the size of the tumor, hearing can sometimes be saved with surgery.
Superior semicircular canal dehiscence
A rare disorder called superior semicircular canal dehiscence (SCD) gives patients who suffer from the disorder a set of symptoms that are frequently confused with other diseases. These symptoms include the sense of motion (or vertigo) induced by loud sounds in one ear or pressure changes, ear fullness, a heightened awareness of internal body noises, and generalized imbalance. Some patients have a sense of motion induced by humming or speaking with their own voice. The disorder results from a weakness in the part of the skull directly over the balance part of the inner ear. It usually occurs in only one ear, but can occur in both. For patients diagnosed with SCD who have severe symptoms the weakness in the bone can be repaired with surgery. Dr. Eisen has extensive experience with these surgeries.
Benign paroxysmal positional vertigo
Tiny crystals in one part of the balance part of the inner ear can get dislodged into a different part of the inner ear and cause a sense of spinning (vertigo) with certain changes in head position. Patients with this disorder frequently say that they get vertigo when they look up or when they turn over in bed. The vertigo lasts for 10 or 20 seconds, but can recur frequently when it is active. This is called benign paroxysmal positional vertigo, or BPPV, and it is the most common reason that people get true spinning vertigo. Once properly diagnosed, which requires a special position testing in the office, it can be treated with dedicated exercises and a maneuver to reposition the crystals into their proper location.
Ménière’s disease is a disorder that involves episodes of hearing loss, fullness in the ear, ringing in the ear, and vertigo (spinning). Episodes can be frequent or infrequent, but can be very disabling. Ménière’s disease occurs when the fluid spaces of the inner ear undergo expansion. There are both medical and surgical treatments available for Ménière’s disease. An exciting new treatment that Dr. Eisen offers to his patients involves putting steroids into the ear through the ear drum. This treatment has excellent results with controlling vertigo and may also help to reduce hearing loss associated with the disease. The procedure is done in the office and carries minimal risk of hearing loss.