Hearing Loss Basics


Balance Problems

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York, PA Office
1776 South Queen Street
(717) 845-6321

Stewartstown, PA Office
200 Bailey Drive, Suite 201
(717) 993-3686

Balance Evaluations

Dizzy, lightheaded, spinning, vertigo

Whatever you call it, nobody likes it. Dizziness, like pain, can be a warning that something else may be wrong. It is the third most common complaint to physicians, resulting in over 6 million office visits a year. Dizziness can occur along with other symptoms. Nausea, anxiety, tinnitus (chronic ringing in the ears), hearing loss, aural fullness or ear pressure should be brought to the attention of a primary care doctor or one of our Audiologists.

Watch a video message about our Balance treatment services.

Almost 85% of dizziness complaints can be attributed to inner ear disturbances. Dizziness can be a symptom of inner ear infection, cardiovascular problems like high blood pressure or anemia, reaction to medications, or other potential problems. It is very important to report symptoms of dizziness or unsteadiness to your physician.

At AC Hearing, Tinnitus and Balance Associates, we treat dizziness with Audiology, physical therapy and physician support to establish the proper diagnostic and treatment options.

Are You In Danger of Falling?

To help determine if you may be headed for a fall, take our Balance Self Test below. 

• Have you fallen more than once in the past year?



• Do you take medicine for two or more of the following diseases: heart disease, hypertension, arthritis, anxiety or depression?



• Do you feel dizzy or unsteady if you make sudden changes in movement, such as bending down or turning quickly?



• Do you have black-outs or seizures?



• Have you experienced a stroke or other neurological problem that has affected your balance?



• Do you experience numbness or loss of sensation in your legs and/or feet?



• Do you use a walker or wheelchair, or do you need assisstance to get around?



• Are you inactive? (Answer yes if you do not participate  in a regular form of exercise, such as walking 20-30 minutes at least three times a week.)



• Do you feel unsteady when you are walking or climbing stairs?



• Do you have difficulty sitting down or rising from a seated or lying position?



If you answer Yes to one or more of the questions, you could be at risk for a fall. Please complete the form below and we'll show you more about our balance treatment services... and how you can get your life back in balance!



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Are you dizzy or unstable? Read more about our comprehensive Vestibular and Diagnostic Audiology Program..

The balance system is located primarily in the inner ear, but in order to maintain good balance it relies on the smooth transmission of information among the brain, brainstem, eyes, somatosensory system and the inner ear. When there is a disruption of information in any area, the body has a more difficult time determining where it should be, which the brain perceives as being off balance.

The diagnostic process is an art and a science that begins with the partnership between the patient, his or her physician, an Audiologist and a physical therapist.
Diagnosing dizziness is a process that usually involves several tests. It starts with a detailed medical history and physical examination. Specific information describing the patient’s symptoms helps in determining the final diagnosis.

The first test is usually one for hearing to determine if the inner ear has been affected in any way.

Videonystagmography, or VNG for short, is the primary test for determining inner ear vestibular function, which tests the transmission of information by the individual peripheral components of the balance system and the interpretation by the central vestibular system. The The VNG is a series of non-invasive computerized tests to evaluate this transfer of information, and may take up to one and a half hours.

Platform Posturography is utilized to evaluate the patient’s ability to maintain balance when visual stimuli is compromised, using a variety of real-life and controlled situations. Limits of stability are checked to indicate the risk of falling. Test results may result in a referral for more advanced testing or rehabilitation. AC Associates’ rehabilitation posturography program allows our professional staff to monitor the progress of therapy in improving stability through intervention as well as identifying patients who need additional evaluation and treatment.

A Dynamic Visual Acuity Test determines the patient’s ability to maintain a visual image during physical movement. Without this ability, the patient’s stability is compromised during movement, and unsteadiness occurs. This test is designed to evaluate angular rotation in a controlled and recordable format, and has been used by the Air Force and Navy to evaluate aviators and divers for normal function in difficult situations. A real world application would be dizziness or unsteady feeling brought on by movement in your environment such as walking down a grocery isle or traffic passing you on a highway.

Balance Treatment and Rehabilitation

Once a diagnosis is determined, we can implement a range of treatments, including physical therapy, that have been proven safe and effective in controlling most of the disorders underlying dizziness. Some severe conditions may need to be controlled with medication, some by diet, and some with surgical intervention. Each patient’s rehabilitation program will be designed by a team assigned to that patient based on the evaluation results.

Each program is individualized according to the patient's diagnosis and prognosis. Success is varied, but patients’ symptoms are alleviated or at least lessened in most cases of peripheral vestibular lesions and benign paroxysmal positioning vertigo (BPPV). Statistically BPPV is the number one cause of dizziness in adults aged 60 years or over.

Disorders of the Auditory System

Auditory Neuropathy is a retrocochlear pathology often characterized with hearing loss identified during pure tone testing, very poor word recognition ability (worse than would be expected based on pure tone results), normal OAEs and abnormal or absent ABR test findings.  This is a disorder which can have genetic basis.  Treatment for auditory neuropathy is quite different from sensori hearing loss, in that amplification is not recommended, but the use of a personal FM system often provides the greatest benefit.  Rare cases of this type of hearing loss are found in children, another reason that the newborn screening program has been implemented. 

Vestibular Schwannoma is a benign tumor of the vestibular portion of the VIIIth nerve, sometimes referred to as an Acoustic Neuroma if impeding on the Auditory portion of the VIIIth nerve.  These are often unilateral; therefore result in unilateral hearing loss and/or tinnitus.  Vestibular Schwannomas are detected through imaging testing, however can be indicated by unilateral sensori hearing loss and absent acoustic reflexes.  Medical treatment may lead to an improvement in symptoms of hearing, and should be monitored by your physician and Audiologist.

Benign paroxysmal positioning vertigo (BPPV) is the number one cause of dizziness in adults aged 60 years or over.  This is characterized by sudden spinning sensation following a turn to one side.  This can follow trauma, and often fatigues over the course of the day.  This is treatable with repositioning therapy and vestibular exercises following appropriate vestibular evaluation.

Meniere’s disease is another well-known cause of dizziness and/or hearing loss.  This is a disease often characterized by unilateral hearing loss and tinnitus described as a “Rushing or Roaring” sensation.  Often this sensation of unilateral hearing disturbance accompanies severe dizziness/spinning.  For many individuals, this is an episodic event, with episodes lasting approximately 2-3 days. For many patients this may be a chronic condition.  Testing may include Audiometry, VNG and VEMP (Vestibular Evoked Myogenic Potentials, depending on symptoms and related findings.

Migraine-associated dizziness is a less-known cause of dizziness.  This is often diagnosed by a Neurologist.  VNG testing as well as Vestibular Evoked Myogenic Potential (VEMP) testing can help pinpoint the correct diagnosis for these individuals.

Superior canal dehiscence is characterized by a feeling of dizziness or lightheadedness following any physical exertion that results in straining.  Some patients may experience this sensation following coughing or sneezing.

Temporal bone fracture can result in dizziness or hearing loss due to structural damage of the semicircular canals (structures of balance) and/or the cochlea (structure of hearing).


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