In the realm of ENT care, headaches are treated as related to sinus disease and tempormandibular joint disorders. Other headaches may require referral to a neurologist for evaluation.

DIZINESS & VERTIGO

A person’s sense of balance is maintained by the inner ear, central nervous system (brain and spine), eyes, joints, sensory receptors and muscles. The inner ear or labyrinth monitors the direction of motion. The eyes observe where the body is in space (i.e. upside down or rightside up) and monitor the direction of motion. Skin pressure receptors tell which part of the body is touching the ground. Muscle and joint sensory receptors tell what part of the body is moving, and the central nervous system processes information from the other systems to make sense of it all. Dizziness and vertigo occur when problems with the balance system occurs. Dizziness and motion sickness occur when the central nervous system obtains differing messages from the other four systems.

Dizziness, also known as disequilibrium, is a central problem resulting from an insufficient amount of blood and air reaching the brain, usually caused by blood vessels to the brain narrowing, blood vessels pinching in a person’s neck and side effects from diabetes and anemia. Dizziness usually occurs when a person stands after he/she has been sitting or reclining and when a person moves his/her head quickly.
Unlike dizziness, vertigo is a peripheral problem, meaning it is usually an inner ear problem. Often times one ear is more affected than the other, which causes an imbalance. Nausea, fullness of the ear, ringing, hearing loss, viral infections, Eustachian Tube Blockage and changes in the inner ear balance portion are all associated with vertigo. Those who suffer from vertigo often say their surroundings are turning or spinning. They also may have nystagmus (involuntary, rapid eye movements which can be spontaneous or can be caused by position changes).
To determine whether the imbalance is dizziness or vertigo, doctors will perform medical evaluations to determine the cause. To provide a diagnosis, doctors will ask your medical history, perform a complete ENT examination and give lab tests, such as blood work and perhaps an EKG. Vertigo is related with loss of hearing, so a hearing test is another possibility in your diagnosis. The hearing test will also determine if your hearing is in the cochlear or retrocochlear area of the inner ear.

Other tests your doctor may suggest are Electronystagmography (ENG), Auditory Brainstem Response (ABR), MRI, a CT Scan or a neuralgic consultation. An ENG evaluates the balance function of the inner ear by placing cool and warm water or air into the ear canal. The ENG will also discover if the dizziness induced during the test is similar to the dizziness experienced in your everyday life. An ABR measures the speed of electrical impulses traveling along the acoustic nerve from the inner ear to the brain. Delayed nerve conduction may be caused by an acoustic neuroma (an uncommon benign tumor in the inner ear). An MRI or CT Scan are used to see many angles of the inner ear and brain and are used to detect any growth in the two areas. Finally, a neurologic consultation might be necessary to determine if the nervous system is causing the balance problems.