Medical & Surgical Subspecialty Care


Dizziness is a common symptom.  More than 40% of adults report dizziness, vertigo, or balance problems to their physician.  It is the second-most common chief complaint heard in the doctor’s office.

The causes of dizziness are multiple.  Often, one particular problem is the main offender, and occasionally, more than one cause can be involved.

Common causes of dizziness include:

  • Medications
  • Dehydration
  • Orthostatic hypotension (decreased blood flow to the brain when standing quickly)
  • Degeneration of the normal balance mechanisms with age
  • Ear disorders (including infections, Meniere’s disease, and positional vertigo)
  • Metabolic deragements
  • Tumors or other disorders of the brain
  • Head trauma
  • Visual problems
  • Post-operative total joint replacement patients

At The Ear Institute, we first determine what organ system is responsible for the patient’s symptom of dizziness.  If an ear disorder is suspected, then further testing may be performed.  This often includes balance testing and a hearing evaluation.  Radiologic studies (CT scans or MRI scans) are occasionally recommended.

How is dizziness treated?

This depends on the cause.  For example, if the cause is a medication, the medication needs to be changed.  If the cause is a blood pressure problem, then the blood pressure is corrected.  If the dizziness is due to an ear problem, the treatment depends on the type of ear disease. Infections are treated with antibiotics, Meniere’s disease (vertigo caused by excessive fluid inside the inner ear) may require diet modification, diuretics or other treatment.  Occasionally, surgery is recommended.  Another common cause of vertigo is BPPV, or “benign paroxysmal positional vertigo”.  BPPV can be effectively treated in the office with a procedure known as the “Epley maneuver”.

Balance Testing

Balance testing typically involves a battery of tests, each one giving different information about the inner ear and central nervous system balance organs.  Although each test alone is neither diagnostic nor therapeutic, it provides supportive information for the physician’s suspected likely diagnosis.  Some of the test can also be used to track a patient’s progress and response to treatment.

Balance Rehabilitation (Vestibular Rehabilitation Therapy) and Falls Prevention

Balance and Vestibular Rehabilitation Therapy provided by Arroyo Physical Therapy. Click here for more information and scheduling.

Patients who suffer from dizziness or vertigo are at risk for falling. Falls can result in serious injury:  hip fractures, brain injury, and even death. In fact, falls are the leading cause of death in individuals over the age of 65, and approximately 20% of patients die within 1 year of suffering a hip fracture.

Balance problems and falling are extremely common, particularly as we get older.  Why?  Age related body changes, such as:  visual deterioration, degeneration of the inner ear, and joint replacement operations all contribute to imbalance and falling.  Many other medical conditions cause imbalance as well.

One of our primary purposes at The Ear Institute is to design customized therapy for each individual with a balance disorder, in order to improve their balance, and prevent serious consequences of a fall.  Following evaluation and diagnosis by the otologist, a treatment plan is developed with the vestibular therapist. This is an exercise-based program, designed to promote central nervous system compensation for inner ear deficits. This plan includes eye, head, ear, and body exercises that retrain the brain’s connections with these body parts.  The brain recognizes and processes signals from the ear and coordinates them with information from the eyes, brain, and position sensors in the joints and feet, to improve balance.  Balance therapy can be extremely effective in improving dizziness, regaining self-confidence, and preventing catastrophic falls.

Physician-driven recommendations on hearing amplification

Hearing loss is a medical condition.  Patients who have a hearing problem should undergo evaluation by a physician, preferably one specializing in diseases of the ear.  The spectrum of ear disease is broad, and the specific conditions we treat are listed here.  Proper treatment may involve medication, and in some instances, surgery.

There are many different options to treat hearing-impaired individuals.  These include hearing aids, FM systems, assistive listening devices, and surgical options as well.

For many patients with age-related hearing loss (presbyacusis), hearing aids are the best solution.  The FDA regulations require that prospective hearing aid users obtain medical clearance from a physician prior to being fit with amplification. There are many dispensaries that will forgo this medical evaluation, by having the patient sign a waiver form.  In rare instances, tumors can cause hearing loss, and for this reason, we recommend against signing a waiver of release from medical clearance.

We specialize in cutting-edge technology for hearing improvement.  Options available to our patients include:  latest technology in standard hearing aids, deep-insertion, or extended-wear hearing aids, hearing implant surgeries (including ossicular prostheses, the Bone Anchored Hearing Aid, and cochlear implants).