Dizziness causes, symptoms and treatments

Illustration explaining types of dizziness.

Dizziness is one of the most frequent reasons people seek out a doctor, and it can be caused by a wide array of illnesses and conditions. If you are experiencing dizziness, a thorough medical evaluation is important.

What is dizziness?

Dizziness is one of the most common

reasons people see a doctor.

Dizziness is a disruption in your sense of balance, and it can come in many different forms—as a sensation of unsteadiness, spinning or general disorientation in relation to your surroundings. You may feel lightheaded, nauseated, woozy or like you might faint.

The body’s balance system

To understand how dizziness occurs, it helps to know how the balance organ and vestibular system work:

The balance organ

Deep within your ears, there are three tiny semicircular canals filled with fluid and crystals, known as endolymph and otoliths. The crystals float and move around in the fluid in response to your body’s angular position. Two other sac-like structures, the utricle and saccule, detect vertical and horizontal movements. Together, these structures are called your balance organ, because they help your body seamlessly detect up from down, left from right, as well as forward and backward motion. 

The vestibular system

The balance organ coordinates with your eyesight and the muscles and joints in your body to provide you with a sense of balance and orientation in your environment. This is medically known as the vestibular system.

Common dizziness symptoms

Dizziness is what happens when there is a deficit in any of the vestibular senses, or the brain centers that tie them all together. Dizziness is not a disease in itself, but a symptom of a larger problem rather than a disease. Many different conditions can cause dizziness, and it’s also a common drug side effect. Even ordinary things—like being on long, hilly car ride—can trigger dizziness in the form of motion sickness.  

There are four main categories of dizziness, according to the American Academy of Family Physicians:

• Vertigo, a false sense of motion
• Disequilibrium, feeling off-balance, unsteady or wobbly
• Presyncope, a feeling of losing consciousness or about to black out
• Lightheadedness, a vague sense of being disconnected with your surroundings

Inner ear causes of dizziness

Some of the most common causes of dizziness arise from problems in your inner ear. A disturbance in the blood circulation or fluid pressure in the inner ear can trigger dizziness and tinnitus. For example, a bad cold can swell your inner ears and lead to bouts of dizziness. You might also experience dizziness if there is pressure on the nerves responsible for delivering balance information to your brain. 

Hearing loss and dizziness: What does it mean?

There are many health conditions that can affect the inner ear and cause both dizziness and hearing loss, including severe allergies, bacterial or viral infections of the inner ear, medication side effects and some circulatory conditions. If you experience sudden dizziness and hearing loss, see a doctor right away.

Ringing in the ears and dizziness

Many disorders that affect the inner ear can potentially lead to ringing in the ears (tinnitus) and dizziness, especially Meniere’s disease. 

Benign paroxysmal positional vertigo (BPPV) typically causes dizziness but no other symptoms. 

Dizziness caused by the inner ear may feel like a whirling or spinning sensation (vertigo), unsteadiness or lightheadedness and it may be constant or intermittent. It may be aggravated by certain head motions or sudden positional changes. Although nausea and vomiting may occur, people do not typically lose consciousness as a result of inner ear dizziness. 

Other causes of dizziness

There are many other causes of dizziness that are not related to the function of the inner ear. They are generally sorted into two categories: central dizziness and visual dizziness.

Central dizziness

If the brain is not able to coordinate the inputs from the three parts of the vestibular system, there is central dizziness. Central dizziness may be caused by migraines, tumors, infections and degenerative diseases like multiple sclerosis. If you’ve ever felt the room spinning after a night of too many alcoholic drinks, than you know what central dizziness feels like.

Visual dizziness

Visual dizziness can occur if the eye muscles are imbalanced or there are errors of refraction, such as when you borrow a pair of eyeglasses from a friend with a different prescription. Other causes of visual dizziness include intermittent inability to focus the eyes, difficulty reading or intermittent blurring of vision.

Other types

Very rarely, dizzy symptoms may be caused by muscle or joint issues, such as unsteadiness due to muscular dystrophy. General health problems, such as diabetes, thyroid deficiency, vitamin deficiency, anemia and arterial blockage can cause dizziness as well.

How your body ‘compensates’

When one part of your vestibular system is afflicted, the other parts can usually compensate for the deficit. Once the system is under too much stress, though, that compensation may fall short. For example, if you must take an ototoxic drug that destroys the balance organs of the inner ear, you can still stay quite balanced as long as your eyes are open. However, when you are asked to close your eyes, you may find it quite difficult to stay standing upright. 

Evaluating dizziness

To figure out what’s causing dizziness, a medical provider must take a thorough medical history and exam. 

Drug interactions

A very common cause of dizziness that is often overlooked is the interaction of one or multiple prescription and/or over-the-counter medications. If you have recently changed or added a prescription to your daily routine, be sure to ask your physician about the possibility of dizziness as a side effect. The same is true of alcohol and caffeine–both can interact with your medications.

A very common cause of dizziness that is often overlooked is the interaction of one or multiple prescription and/or over-the-counter medications.

Tests for dizziness

There are a wide array of tests a doctor may use to evaluate dizziness, and they may be performed by a primary care doctor, a physical therapist, cardiologist or neurologist.

In some cases, especially if you also experience hearing loss, you may undergo a hearing test. The cochlea, your hearing organ, is contained within the same bony structure as your balance organ. A behavioral hearing test in a sound booth may be followed by an Auditory Brainstem Response (ABR) test. An ABR test non-invasively records brainstem responses to sound stimuli. The brain waves are collected while you rest comfortably with your eyes closed. The presence or absence of hearing loss or auditory brainstem anomalies will provide clues to the physician about the cause of your symptoms.

Another common test for balance is VNG, or videonystagmography. Usually performed by an ENT physician or an audiologist, a VNG test uses video cameras to record eye movements while a patient tracks a visual stimulus, is moved into different positions and while the ear canals are stimulated with warm and cool air or water. This test gives a broad picture of whether the underlying issue is related to the inner ear or not.

Treatments for dizziness

Appropriate treatment for dizzy symptoms will depend on the underlying cause, so it is important that you see a physician. Your doctor might prescribe something to help the dizzy symptoms temporarily, for example.

When the cause of the dizziness is determined and treated, the symptom will often go away. For BPPV, dizziness can be treated by a simple head positioning maneuver. 

Many other disorders can be treated with medication, surgery, diet, lifestyle changes or some combination of these. There are also physical therapists who specialize in vestibular rehabilitation, which is a treatment for balance disorders that gradually retrains the brain to compensate for lost sensory input from the balance system. 

Dizziness and anxiety

People with chronic episodes of dizziness may develop anxiety or even panic attacks. This is because dizziness is a very scary situation in which you may feel not just miserable (and nauseated), but helpless.  

More: Why anxiety often accompanies balance disorders, and what to do about it

When to get help

If you experience any dizziness symptoms that don’t go away, you should talk to your physician or a hearing care provider so the underlying cause can be determined and the problem remediated.

Joy Victory, managing editor, Healthy Hearing

Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public.
Read more about Joy.

Labyrinthitis – Illnesses & conditions

Labyrinthitis is usually treated using a combination of self-help techniques and medication. Chronic labyrinthitis may be treated with vestibular rehabilitation therapy (VRT).

Self-help

Drink plenty of liquid, little and often, particularly water, to avoid becoming dehydrated.

In its early stages, you may feel constantly dizzy and it can give you severe vertigo. You should rest in bed to avoid falling and injuring yourself. After a few days, the worst of these symptoms should have passed and you should no longer feel dizzy all the time.

You can do several things to minimise any remaining feelings of dizziness and vertigo. For example:

• during an attack, lie still in a comfortable position (on your side is often best)
• avoid alcohol
• avoid bright lights
• try to cut out noise and anything that causes stress from your surroundings

You should also avoid driving, using tools and machinery or working at heights if you’re feeling dizzy and unbalanced.

Medication

If your dizziness, vertigo and loss of balance are particularly severe, your GP may prescribe a short course of medication such as benzodiazepine or antiemetics (vestibular sedatives).

Benzodiazepine

Benzodiazepines reduce activity inside your central nervous system. This means your brain is less likely to be affected by the abnormal signals coming from your vestibular system.

However, long-term use of benzodiazepines is not recommended because they can be highly addictive if used for long periods.

Antiemetics

A prescription medication known as an antiemetic may be prescribed if you’re experiencing nausea and vomiting.

Prochlorperazine 5mg tablets are an antiemetic used to treat the symptoms of vertigo and dizziness. It may be considered as an alternative treatment to benzodiazepines.

Most people are able to tolerate prochlorperazine and side effects are uncommon, but can include:

• tremors (shaking)
• abnormal or involuntary body and facial movements
• sleepiness

If you are vomiting, there is a prochlorperazine 3mg tablet available which you place inside your mouth between your gums and cheek.

Corticosteroids

Corticosteroids such as prednisolone may be recommended if your symptoms are particularly severe. They are often effective at reducing inflammation.

Antibiotics

If your labyrinthitis is thought to be caused by a bacterial infection, you will be prescribed antibiotics. Depending on how serious the infection is, this could either be antibiotic tablets or capsules (oral antibiotics) or antibiotic injections (intravenous antibiotics).

Check the patient information leaflet that comes with your medicines for a full list of possible side effects.

When to seek further advice

Contact your GP if you develop additional symptoms that suggest your condition may be getting worse. If this happens, you may be admitted to hospital. These symptoms include:

• mental confusion
• slurred speech
• double vision 
• weakness or numbness in one part of your body
• a change in the way you usually walk

Also contact your GP if you do not notice any improvement after three weeks. You may need to be referred to an ear, nose and throat (ENT) specialist.

Chronic labyrinthitis

A small number of people experience dizziness and vertigo for months or even years. This is sometimes known as chronic labyrinthitis.

The symptoms are not usually as severe as when you first get the condition, although even mild dizziness can have a considerable impact on your quality of life, employment and other daily activities.

Vestibular rehabilitation therapy (VRT)

Vestibular rehabilitation therapy (VRT) is an effective treatment for people with chronic labyrinthitis. VRT attempts to “retrain” your brain and nervous system to compensate for the abnormal signals coming from your vestibular system.

VRT is usually carried out under the supervision of a physiotherapist and involves a range of exercises designed to:

• co-ordinate your hand and eye movements
• stimulate sensations of dizziness so your brain starts to get used to disruptive signals sent by your vestibular system and then ignores them
• improve your balance and walking ability
• improve your strength and fitness

The Brain and Spine Foundation is a UK charity that has more information about vestibular rehabilitation on its website.

You can ask your GP to refer you to a physiotherapist or you can pay for private treatment. If you decide to see a private physiotherapist, make sure they are fully qualified and a member of a recognised body, such as the Chartered Society of Physiotherapy (CSP).

Not all physiotherapists have training in VRT, so you need to make it clear you require this type of treatment before making an appointment.

Labyrinthitis and vestibular neuritis – NHS

Labyrinthitis is an inner ear infection that affects your balance. It’s sometimes called vestibular neuritis. It usually gets better by itself within a few weeks.

Check if you have labyrinthitis

The most common symptoms of labyrinthitis are:

• dizziness or feeling that everything around you is spinning (vertigo)
• feeling unsteady and off balance – you might find it difficult to stay upright or walk in a straight line
• feeling or being sick
• hearing loss
• ringing in your ears (tinnitus)

Symptoms can start suddenly. They may be there when you wake up and get worse as the day goes on.

The symptoms often ease after a few days.

You’ll usually get your balance back over 2 to 6 weeks, although it can take longer.

Things you can do to help

Labyrinthitis usually gets better on its own. But there are things you can do to ease the symptoms:

Do

• lie still in a dark room if you feel very dizzy

• drink plenty of water if you’re being sick – it’s best to drink little and often

• try to avoid noise and bright lights

• get enough sleep – tiredness can make symptoms worse

• start to go for walks outside as soon as possible – it may help to have someone with you to steady you until you become confident

• when you’re out and about, keep your eyes focused on a fixed object, rather than looking around all the time

Don’t

• do not drive, cycle or use tools or machinery if you feel dizzy

• do not drink alcohol – it can make symptoms worse

Non-urgent advice: See a GP if you have:

• symptoms of labyrinthitis that do not get better after a few days
• symptoms of labyrinthitis that are getting worse
• been diagnosed with labyrinthitis and your symptoms have not improved after another week

The GP may refer you to a hospital specialist.

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

• visit their website
• use the NHS App
• call them

Find out about using the NHS during COVID-19

Urgent advice: Ask for an urgent GP appointment or call 111:

• if you have sudden hearing loss in 1 ear

You may need to be referred to a specialist for tests, and possibly treatment.

Information:

Labyrinthitis and vestibular neuritis – what’s the difference?

Labyrinthitis and vestibular neuritis are problems with different parts of the inner ear, which are needed for balance:

• Labyrinthitis is inflammation of the labyrinth – a maze of fluid-filled channels in the inner ear
• Vestibular neuritis is inflammation of the vestibular nerve – the nerve in the inner ear that sends messages to the brain

The symptoms of vestibular neuritis and labyrinthitis are very similar.

However, if your hearing is affected, then labyrinthitis is the cause. This is because inflammation of the labyrinth affects hearing, while inflammation of the vestibular nerve does not

Treatment from a GP for labyrinthitis

If you have labyrinthitis, a GP may prescribe antihistamines or motion-sickness tablets for up to 3 days. Do not take them for any longer, as they can slow down your recovery.

Labyrinthitis is usually caused by a viral infection, such as a cold or flu, so antibiotics will not help. But a GP may prescribe antibiotics if they think your infection is bacterial.

Exercises for long-term balance problems

Sometimes, balance problems can last for much longer – for many months or even years.

Vestibular rehabilitation is a series of exercises that can help restore balance. You should only do the exercises under the supervision of a physiotherapist.

You can ask a GP to refer you to a physiotherapist, or it may be possible to refer yourself directly.

Waiting lists for NHS physiotherapy can be long and you may prefer to pay for private treatment. Most private physiotherapists accept direct self-referrals.

Read more about accessing physiotherapy.

Information:

The Brain & Spine Foundation has a factsheet about vestibular rehabilitation exercises

Video: labyrinthitis and vertigo (BPPV) – Hazel’s story

In this video, Hazel talks about how labyrinthitis affected her balance and perception and how she found help.

Media last reviewed: 1 July 2020
Media review due: 1 July 2023

Page last reviewed: 11 February 2020
Next review due: 11 February 2023

Dizziness Balance Disorders | Ear Associates of San Jose California

What is a balance disorder?

A balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating. An organ in our inner ear, the labyrinth, is an important part of our vestibular (balance) system. The labyrinth interacts with other systems in the body, such as the visual (eyes) and skeletal (bones and joints) systems, to maintain the body’s position. These systems, along with the brain and the nervous system, can be the source of balance problems.

Three structures of the labyrinth, the semicircular canals, let us know when we are in a rotary (circular) motion. The semicircular canals, the superior, posterior, and horizontal, are fluid-filled. Motion of the fluid tells us if we are moving. The semicircular canals and the visual and skeletal systems have specific functions that determine an individual’s orientation. The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ). The vestibular system works with the visual system to keep objects in focus when the head is moving. Joint and muscle receptors also are important in maintaining balance. The brain receives, interprets, and processes the information from these systems that control our balance.

What are some types of balance disorders?

Some of the more common balance disorders are:

What are the symptoms of a balance disorder?

When balance is impaired, an individual has difficulty maintaining orientation. For example, an individual may experience the “room spinning” and may not be able to walk without staggering, or may not even be able to arise. Some of the symptoms a person with a balance disorder may experience are:

• A sensation of dizziness or vertigo (spinning).
• Falling or a feeling of falling.
• Lightheadedness or feeling woozy.
• Visual blurring.
• Disorientation.

Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period of time.

What causes a balance disorder?

Infections (viral or bacterial), head injury, disorders of blood circulation affecting the inner ear or brain, certain medications, and aging may change our balance system and result in a balance problem. Individuals who have illnesses, brain disorders, or injuries of the visual or skeletal systems, such as eye muscle imbalance and arthritis, may also experience balance difficulties. A conflict of signals to the brain about the sensation of movement can cause motion sickness (for instance, when an individual tries to read while riding in a car). Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort. Balance disorders can be due to problems in any of four areas:

• Peripheral vestibular disorder, a disturbance in the labyrinth.
• Central vestibular disorder, a problem in the brain or its connecting nerves.
• Systemic disorder, a problem of the body other than the head and brain.
• Vascular disorder, or blood flow problems.

How are balance disorders diagnosed?

Diagnosis of a balance disorder is complicated because there are many kinds of balance disorders and because other medical conditions–including ear infections, blood pressure changes, and some vision problems–and some medications may contribute to a balance disorder. A person experiencing dizziness should see a physician for an evaluation.

The primary physician should rule out some basic medical problems such as anxiety, migraine, diabetes and other medical problems. He may request the opinion of an otologist to help evaluate a balance problem. An otologist is a physician/surgeon who specializes in diseases and disorders of the ear with expertise in balance disorders. He or she will usually obtain a detailed medical history and perform a physical examination to start to sort out possible causes of the balance disorder. The physician may require tests to assess the cause and extent of the disruption of balance. The kinds of tests needed will vary based on the patient’s symptoms and health status. Because there are so many variables, not all patients will require every test.

Some examples of diagnostic tests the otolaryngologist may request are a hearing examination, blood tests, an electronystagmogram (ENG–a test of the vestibular system), or imaging studies of the head and brain.

The caloric test may be performed as part of the ENG. In this test, each ear is flushed with warm and then cool usually one ear at a time; the amount of nystagmus resulting is measured. Weak nystagmus or the absence of nystagmus may indicate an inner ear disorder.

Another test of the vestibular system, posturography, requires the individual to stand on a special platform capable of movement within a controlled visual environment; body sway is recorded in response to movement of the platform and/or the visual environment.

How are balance disorders treated?

There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, such as ear infection, stroke, or multiple sclerosis. Individual treatment will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests.

Another treatment option includes balance retraining exercises (vestibular rehabilitation). The exercises include movements of the head and body specifically developed for the patient. This form of therapy is thought to promote compensation for the disorder. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body.

For people diagnosed with Ménière’s disease, dietary changes such as reducing intake of sodium may help. For some people, reducing alcohol, caffeine, and/or avoiding nicotine may be helpful. Multiple other medical and surgical treatments exist for Ménière’s disease. A program of talk therapy and/or physical rehabilitation may be recommended for people with anxiety.

A program of talk therapy and/or physical rehabilitation may be recommended for people with anxiety.

How can I help my doctor make a diagnosis?

You can take the following steps that may be helpful to your physician in determining a diagnosis and treatment plan.

• Bring a written list of symptoms to your doctor.
• Fill in the health history form at this link prior to your appointment.
• Bring related copies of previous hearing, balance or medical tests.
• Bring a list of medications currently being used for balance disorders to your doctor.
• Be specific when you describe the nature of your symptoms to your doctor. For example, describe how, when, and where you experience dizziness.

Lastly, remember to write down any instructions or tips your doctor gives you.

Migraine Associated Dizziness (MAD)

Migraine is a type of headache (HA) characterized by throbbing pain limited to one side of the head and sometimes accompanied by nausea, vomiting and sensitivity to light and sound. Migraine headaches are one of the most common causes of dizziness. Dizziness in migraine may occur with the HA, prior to or after the HA or completely independent of the HA. It is common to have dizziness as the only symptom of a migraine HA. The dizziness may be vertigo (sensation of spinning), imbalance or sensitivity to motion. Ear fullness and tinnitus may also occur.

How common is MAD?

Migraines are more common in women than men, especially women of childbearing age. Approximately, one third of the migraine patients have dizziness. People who suffer from migraines with aura are more likely to have dizziness with the HA. Sensitivity to motion, as in car sickness, amusement park rides, fast moving objects, is reported in half of the patients with migraines and can be the only symptom of a migraine. In young children, typically younger than 4 years old, sudden brief episodes of loss of balance with vomiting, anxiety, and nystagmus occur that are thought to be migraine equivalents. About 50% of these children develop migraines later in life.

What causes dizziness in MAD?

There are many theories and the exact cause is not know. People who are prone to migraines, when exposed to certain triggers, likely undergo changes in the brain associated with release of certain chemicals. These changes can cause dizziness along with HA.

How is MAD diagnosed?

A detailed history about the HAs, dizziness, triggers and many other factors along with a careful physical examination begin the diagnostic process. A hearing test is performed. Migraines may cause hearing loss and tinnitus (ringing of the ears) which also occurs in other ear conditions, and so a full diagnostic audiogram is required. Other diagnostic tests, electronystagmography(ENG) and electrocochleography(ECOG) and CDP may be performed. An MRI of the brain and inner ear is sometimes performed. A symptom diary, migraine diet and observation are sometimes performed as part of the diagnostic process.

What is the treatment?

The first step in the treatment is avoiding migraine triggers. Keeping a symptom diary helps to know your triggers. Certain foods are known migraine triggers and are listed below. There are many medications used to prevent migraine and they help prevent MAD. Vestibular and balance therapy is helpful to resolve the motion sensitivity associated with MAD. (link to balance therapy)

MIGRAINE PREVENTION

BEHAVIORAL PREVENTION

• Diet- Don’t Skip Meals.
• Sleep- Regular to bed and arise times.
• Caffeine/Chocolate- Gradual taper
• Fluids- Eight (8) ounce glasses of h3O daily.
• Exercise- Cardiovascular 30 – 60 minutes, three (3) days a week.
• Biofeedback, relaxation therapy

MIGRAINE DIET TRIGGERS

AVOID

• Caffeine (including chocolate).
• Alcohol, especially red wine, and other alcoholic beverages.
• Monosodium glutamate (MSG), may also be labeled “autolyzed yeast.
  Extract,” “hydrolyzed vegetables protein,” or “natural flavoring.”
  Possible sources of MSG include: Chinese Restaurant: broth or stock:
  Canned or instant soup: whey protein; soy extract; malt extract; caseinate;
  Barley extract; textures soy protein; chicken, pork or beef flavoring;
  Processed meats; smoke flavor; spices and seasonings; including season
  Salt; carrageenan; meat tenderizer; TV dinners; instant gravy; and some
• Potato chips and dry roasted nuts.
• Aged cheeses such as Cheddar, Blue, Brick, Colby, Roquefort, Brie,
  Gruyere, Mozzarella, Parmesan, Boursault and Romano.
• Diet sodas or other products sweetened with NutraSweet or Equal.
• Processed meats (sodium nitrate as preservative) to include hot dogs,
  Pepperoni, Bologna, salami, sausage, canned or aged meats, cured meat
  e. g., bacon, ham or marinated meat;
• Dried fruits treated with sulfur dioxide.

Vestibular Neuritis (VN)

Researches believe this condition is caused by an inflammation of the nerve of the inner ear. The nerve, called the vestibulocochlear nerve brings information from the balance system (vestibular) and the organ of hearing (cochlea) of the inner ear to the brain. Inflammation of the part of the nerve that supplies the balance system causes sudden onset of dizziness or vertigo known as vestibular neuritis. The lay persons’ term for this is labyrinthitis.

What are the causes of vestibular neuritis?

Viral infection is thought to be the cause, although there is still uncertainty. Viruses from the herpes family and reactivation of chicken pox virus are linked to VN.

What are the symptoms of vestibular neuritis?

VN is characterized by sudden onset of severe debilitating vertigo, which is the sensation of spinning of the head or the environment. Initially this is a constant sensation worsened by head or body movements. Associated with vertigo are severe imbalance, nausea, and vomiting. The symptoms decrease in severity from constant to episodic in nature over a period of days. About 15% of patients with VN develop BPPV.

How is vestibular neuritis diagnosed?

Diagnosis is made after obtaining a detailed history of symptoms and performing a complete physical and neuro-otologic examination. A diagnostic hearing test is performed during the initial evaluation. Blood work is also ordered to check for infection. Electrophysiologic testing of the hearing and balance system and other tests are sometimes performed. done. An MRI is often ordered.

How is vestibular neuritis treated?

Vestibular neuritis is treated symptomatically. Medications are given for nausea, vomiting and dizziness. If onset of VN is recent then oral steroids may help to decrease the severity of dizziness. If vomiting is uncontrollable, admission into a hospital is required for intravenous rehydration. Vestibular rehabilitation exercises are very beneficial in the treatment of this conditions.

What Is BPPV?

BPPV or Benign Paroxysmal Positional Vertigo is one of the most common disorders of the inner ear that results in vertigo. It is due to particles (crystals, otoliths,”ear rocks”) that have collected in the fluid filled balance canals of the inner ear. These particles, made of calcium, float in the fluid and will occasionally touch a sensitive area resulting in the sensation of vertigo. The name of this disorder is derived from the fact that BPPV is Benign (not life threatening), Paroxysmal (dizziness occurs suddenly and briefly), Positional (dizziness occurs with particular head positions) and causes Vertigo (sensation of spinning). BPPV is a common cause of dizziness. About 20% of all dizziness is due to BPPV. In older people, half of the patients with dizziness may have BPPV.

WHAT ARE THE SYMPTOMS OF BPPV?

The symptoms can vary in each person and include dizziness or vertigo, lightheadedness, imbalance, and sometimes nausea and vomiting with head movements. The symptoms are almost always precipitated by a positional change of the head or body. Getting into or out of bed, or rolling over in bed are common “problem motions”. Some people will feel dizzy and unsteady when they tilt their heads back such as looking up, brushing their teeth, washing their hair, instilling eye drops, or checking the “blind spots” while driving. Although many people feel normal when not in a “problem” position, some do have a sensation of imbalance.

BPPV has often been described as “self-limited” because symptoms often subside or disappear within six months of onset. Symptoms tend to wax and wane. The symptoms can last for days or occasionally months.

WHAT CAUSES BPPV?

The most common cause of BPPV in people under age 50 is head injury. It is more common in older people, commonly due to degeneration of the balance system of the inner ear. A viral upper respiratory infection or allergy flare up may also play a role. It also occurs commonly in people with Meniere’s disease and otosclerosis and after surgical and dental procedures. Minor stroke of the blood vessels supplying inner ear or a tumor of the inner ear are rare causes of BPPV. However, in perhaps half of all cases, BPPV is called “idiopathic”, which means it occurs for no known reason.

HOW IS THE DIAGNOSIS MADE?

Your doctor will make the diagnosis based on your symptoms, physical examination and the results of your hearing and balance tests. During medical evaluation, Dix Hallpike test will be performed which helps to make the diagnosis of BPPV. During this test, the head is turned and the lies down quickly from a sitting position to hang the head at a 45 degree angle over the side of the table or bed. This is then repeated with the head turned to the other side. If there is a crystal, these movements cause a quick burst of nystagmus (jumping of the eyes) thus confirming the diagnosis of BPPV. Occasionally other tests may be required. A video nystagmography test (VNG) test may be needed to look for the characteristic eye movements and other possible causes of vertigo. An MRI scan would be performed if there is any possibility of a stroke or brain tumor. Although rare, it is possible to have BPPV in both ears, which may make the diagnosis and treatment more challenging.

HOW IS BPPV TREATED?

Motion sickness medications (Meclizine, Dramamine, Bonine etc) are rarely effective and often worsen balance. These should be discontinued 48 hours prior to your doctor’s appointment for the evaluation of dizziness as they may interfere with the physical findings. Once the diagnosis of BPPV is confirmed, an in office treatment called an “Epley maneuver” is performed. This is effective in treating over 90% of cases. Other maneuvers exist to treat resistant or more complicated cases. A surgical procedure called “posterior semicircular canal occlusion” may be used to treat BPPV in the rare person where maneuvers fail.

OFFICE TREATMENT OF BPPV (THE EPLEY MANEUVER)

The Epley maneuver (also called the particle repositioning or canalith repositioning procedure) involves sequential movement of the head through four positions while lying down. A hand held massager is applied to the bone behind the ear during these head movements. The procedure t moves the crystals from the balance canals back to their normal location where they do not cause any vertigo. The entire procedure takes about 10 minutes. It is best to have someone drive you to your appointment as you may feel dizzy after the maneuver. You will be given a cervical collar and certain instructions to follow that help in making this treatment a success. It is best to come to your appointment on an empty stomach. The maneuver can very rarely cause vertigo to worsen temporarily.

INSTRUCTIONS FOR PATIENTS AFTER OFFICE TREATMENT (EPLEY MANEUVER)

To increase the success of the Epley maneuver you will be asked to:

• Wear the cervical collar for the next 7 days during the daytime
• You will take it off for napping or sleeping
• For the first 2 nights, sleep upright or at a 45 degree angle, in a recliner or in your bed with pillows behind your back.
• From 3rd night onwards, sleep on your back or on the opposite (unaffected) ear.
• You will be seen in one week for a follow up appointment to check for the resolution of vertigo

This treatment has a cure rate of 80% and repeat treatments may be necessary in the other 20% of the symptomatic patients. In rare cases, if repeat treatments fail, a surgical procedure called posterior semicircular canal occlusion can be performed.

WHAT TO EXPECT AFTER SUCCESSFUL TREATMENT

Some people may feel lightheaded, imbalanced or “woozy” even after the treatment has been successful. These patients are put on a regimen of daily at home head and neck exercises for rehabilitation of the balance system. BPPV often recurs, in 30% within one year and 50% within five years.

Any vertigo accompanied by a change in hearing, blurring or double vision, severe headaches, numbness or tingling of body with difficulty speaking and swallowing, or loss of consciousness is an indication of a more serious medical condition and should be evaluated urgently.

Foolproof Techniques for Removing Water from Your Ears | LeMay Hearing & Balance

For many people in Reno, summer means splashing through fountains or taking a dip in the pool to escape the heat. While that’s a great way to cool off, if water becomes trapped in your ears, it can lead to infection – and possibly even impact your hearing. We have some tips that will help you get rid of water from your ears and prevent health complications.

These Tips Will Help Get Rid of Water in Your Ears

Water in your ears can cause a plugged-up sensation and make sounds appear muffled. You might experience ear pain, tinnitus, hearing loss and loss of balance and coordination, a runny nose or a sore throat. When water accumulates in the ear and doesn’t drain properly, you risk developing swimmer’s ear, surfer’s ear or another type of infection that can cause hearing loss if left untreated.

The following techniques should help you get rid of water trapped in your ears.

• The Gravity/Jiggling Technique. Lie on the ground with your affected ear parallel to the floor, tilt your head and jiggle your earlobe. Gravity will take care of the rest! You can use a cotton swab to remove any water remaining in your ears.
• The Valsalva Maneuver. Scuba divers and airline travelers are familiar with this trick. It involves plugging your nose and blowing it using modest force; this helps to normalize the pressure in your ears and should allow water to drain.
• The Vacuum Technique. Placing the palm of your hand over your plugged-up ear and pressing gently for a few seconds will create a suction effect that should help dislodge water from the canals. Repeat until it is all gone.
• The Hairdryer Technique. Using a hairdryer on its lowest heat setting and aiming it at your ear (don’t get too close) will help the water to evaporate and dry out your ear canals. Don’t worry, if you don’t get rid of it all at first, the rest should drain on its own.
• The Pulling Technique. Reach around the back of your head and tug gently on the outer portion of your ear with your opposing hand. This will straighten out the ear canal and allow water to drain out.
• The Chew and Yawn Technique. Moving your mouth and jaw help equalize pressure in the Eustachian tubes. Try chewing gum and yawning to encourage built-up water to drain out. Shaking your head afterwards provides an extra assist if you can’t quite get it all.
• The Chemical Technique. If none of these natural techniques help, there are a number of over-the-counter alcohol-based ear drops designed to remove moisture from the ear canals.

Your audiologist in Reno recommends wearing swim plugs or a swim cap whenever you are going to be exposed to water in order to prevent it from entering your ears, and to dry them thoroughly afterwards. If you have water trapped in your ears and can’t get it out using these techniques, make an appointment as soon as possible.

Call LeMay Hearing & Balance at (775) 323-5566 for more information or to schedule an appointment.

Ear Wax

Timothy C. Hain,
MD at Chicago Dizziness and Hearing • Last edited:

March 7, 2021

Ear Wax Defined •
Wax Problems•
Treatment• Foreign bodies

Ear
wax defined

Ear wax is a normal product of the ear which protects the skin of the ear from
water and infection. Ear wax is formed from wax glands in the external ear canal
as well as other components such as dead skin, sweat, and oil. The primary component
of ear wax is keratin (derived from dead skin). Ear wax thus differs slightly
from cerumen which is the secretory product of the ceruminous glands
in the external auditory canal (Hawke, 2002). Ear wax is not a foreign body — it is an intrinsic product of the lining of the ear. If you are interested in other stuff in the ear (like bugs), see this page.

While ear wax is generally simply
felt to be a nuisance, in medieval times, ear wax was used as a component of
pigment for illumination of manuscripts (Petrakis, 2000). Anthropologists have used cerumen type to tract human migratory patterns and epidemiologists have related cerumen type to breast cancer. (Roeser et al, 1997).

Different individuals vary considerably in the amount and consistency of their
ear wax. There are two types described, wet and dry, which are inherited. Dry
wax is common in Asia, while wet wax is common in western Europe. Dry wax, also
known as “rice-bran wax”, contains by weight about 20% lipid (fat).
Oddly enough, rice-bran wax is associated with a lower incidence of breast cancer
(Hawke, 2002). According to Japanese researchers, a gene known as ATP-binding casette CII is important in controlling the type of ear wax you have. Without the contribution of this gene, one has dry (rice-bran) ear wax. (Yoshiura, Kinoshita et al. 2006). The high prevalence of dry wax may account for why the Japanese have so many
ways of removing it (i.e. mimikaki).

Wet wax consists of approximately 50% fat (Burkhart et al, 2000). Wet wax
can be either soft or hard, the hard wax being more likely to be impacted. Too
little ear wax increases the risk of infection (Fairey et al, 1985). Too much
wax also increases the incidence of infection and hearing loss. So, you want
just enough.

While we are not aware of a study of this, some people (and some ears) are
“wax producers”, and others remain wax free without much maintenance. This has some impact on ear wax management (see below). Two populations are known to have a high incidence of excessive/impacted cerumen: individuals with mental retardation and the elderly. (Roeser et al, 1997).

Audiogram prior to ear wax removal (decreased hearing at both low and high pitches on the right (circles) compared to the left (x’s).	Audiogram after ear wax removal.

What can go wrong with ear wax ?

1. Wax can plug up the ear, causing hearing to be reduced, and a full feeling
   in the ear. This is called an “impaction”. About 2-6% of the population has an ear wax impaction at any time.  An example of the effect on hearing is shown above.
2. Wax can trap bacteria or fungus or other stuff in the ear, leading to infection. This is usually
   painful or at least itchy.
3. Ear wax can obscure vision when the doctor looks in your ears, possibly
   hiding a dangerous process.
4. Ear wax is the most common cause of hearing aid malfunction

How does one know one has ear wax ?

Direct vision is the easiest way. An otoscope is used to visualize the wax.

How is ear wax treated ?

Problematic wax can be removed with drops, with water jets (“irrigation”),
with suction, and with instruments by a doctor, audiologist or a trained technician. If a person
has chronic ear disease, a perforation of the ear drum, or has wax in their
only hearing ear, it is recommended to have wax removed by an ear
doctor under direct vision. If there is a perforation in the ear drum, or a reasonable possibility of a perforation, wax should be removed by instruments and/or suction, and not by irrigation.

Wax removal under direct vision. A metal speculum (the trumpet shaped device) is placed in the ear canal. Wax is removed using an instrument called a “cerumen spoon”, sometimes supplemented with gentle suction and forceps. Ordinarily this is done using an examining microscope (not shown), which provides magnification and a bright light.	These small impacted cerumen laying over the ear drum may cause up to 15db drop in hearing in long term hearing aid users. (Courtesy of Dr. Bulent Mamikoglu)	Ear after cleaning. (Courtesy of Dr. Bulent Mamikoglu)

The best way: removal under direct vision by a doctor or other
professional is the best method of getting wax out, but it requires a doctors
visit and the doctor must have access to an examining microscope. Practically speaking,
this generally requires yearly visits to see a specialist called an “otologist”.
The ear doctor will remove wax with a cerumen spoon, or suction, or both.

This method may be a little painful – not awful — but not entirely pleasant. The reason is that wax is often embedded into the hair that grows onto the side of the ear canal. When one takes the wax out using a cerumen instrument, hair often comes with it — this can hurt. This particular problem can be avoided by softening up the wax first with some oil (we often recommend Debrox) — or by irrigating it out (see below).

In persons who have a very large amount of ear wax, putting drops into the ear may simply block up the ear and make it wet. Because of this consideration, the optimal method of doing this is to have someone look into your ear first, and act depending on the situation.

People accumulate wax at different rates, and also have different types of wax. Below is our usual algorithm for wax management:

• No wax — do nothing
• Small amount wax — do nothing
• Moderate amount of wax — take it out with microscope. Recheck in 6 months.
• Large amounts of hard wax — take out as much as can be easily removed with microscope, and have person use drops, return in a few days to a week for suction. Recheck in 3 months.
• Large amounts of wax, already soft. Take out with suction or irrigation. Recheck in 3 months.

Irrigation:

Irrigation or “syringing” is a standard method of wax removal and approximately 150,000 ears are irrigated each week in the United States (Grossan, 1998). To avoid inducing dizziness, body temperature water is preferred. While irrigation is a conventional and accepted method of ear wax removal, it has many disadvantages compared to removal under direct vision. For example, in the rare instances when there is a perforation under the wax, irrigation may force water and wax into the middle ear, causing a nidus for infection. Irrigation also puts the ear to risk for bacterial infection. Some authors recommend placing 1 or 2 drops of Domeboro, Vosol or Cortisporin otic in the irrigated canal to prevent infection. Irrigation should not be used in ears with perforations.

Sometimes ear wax is hardened and impossible to remove with irrigation. In this situation one may attempt to soften the wax with oil and return in one week for another attempt. Suction may be helpful in this situation.

Water jet devices such as used for dental care have also been used for ear wax removal. While generally effective, this method is judged unpleasant by many patients. There is also danger of perforation of the ear drum using these devices. Special tips can be used to reduce or eliminate this risk.

The Welch Allyn Ear Wash System simultaneously irrigates and suctions out water and wax in a single step. This system is used in our practice in Chicago, and is very well tolerated. We also have a video otoscope that allows people to see their ear wax, “in situ”, on a very large monitor. This is just if you really want to see whats in there.

Drops:

With respect to using drops, the current literature is inconclusive and basically suggests that nearly anything wet works as well as anything else. Over the counter drops that help remove wax are largely basically water, oil
and peroxide solutions (e.g. brand names are Debrox). Among the solutions are
ordinary water, 10% sodium bicarbonate, 3% hydrogen peroxide, 2% acetic acid,
and a combination of 0.5% aluminum acetate and .03% benzethonium chloride (Hawke,
2002). Hydrogen peroxide is present for the mechanical effect — of course it does not
dissolve ear wax (Burkhart et al, 2000). These preparations are best for those
with small to moderate amounts of wax.

Among oil-based organic solutions are
olive oil, glycerin, propylene glycol, and others. Warming of solutions used
for wax removal sometimes is helpful. According to Hawke, oil based preparations
basically do nothing but lubricate (Hawke, 2002).

Some preparations are enzyme
based. We advise against use of “enzyme” based preparations, because
of problems with allergy.

NONE OF THESE PREPARATIONS SHOULD BE USED IN PERSONS
WHO HAVE A EARDRUM PERFORATION.

In many patients, a wax plug blocks the ear
so one cannot know for sure if a perforation is present. However in this situation,
it is usually possible to make an educated guess with a reasonable degree of
reliability (Hawke, 2002).

There are also preparations intended to dissolve ear wax — for example, Cerumenex
Ear Drops and Murine Ear drops. Neither of these
preparations are any better than salt water. This is not to say that they are worthless — just that salt water is equally effective (Roland et al, 2004).

Colace (a liquid stool softener), having the active ingrediant of docuate, when dropped in the ear, has also been studied for ear wax control. It has not been shown to have any advantages or disadvantages over other preparations. (see Cochrane Review). Docusate is ototoxic in guinea pigs (Nader et al, 2011), and for this reason, should be especially avoided when there is any chance of a perforation.

Dermotic drops are a mixture of oil and steroids. They can be used for itchy ears. They are not useful for ear wax per se.

“Candling” is an “alternative” method of removing wax.
This method is not felt to be effective. There is an obvious risk of burning your ear.

The “NeilMe

The “NeilMed” clearcanal Earwax removal kit. appears to be a do-it-yourself irrigation kit. We are OK with the ear syringe and the peroxide (which is similar to other ear wax commercial products), but we are a little puzzled about the spray can. Why do we need a spray can for salt water ? We had one patient that reported getting BPPV from this kit. We would also expect it might cause dizziness from the temperature effect.

Ear Wax Maintenance

First, one should realize that wax isn’t all that bad. It keeps your ear dry and helps
prevent infection. So, you don’t want to eliminate wax, but just keep it from blocking
your ear.

How can one keep wax from blocking the ear ? There are several methods. The first two involve putting liquids into the ear, and should not be used by people with a hole in their ear drum (perforation).

One method is to put baby oil or olive oil into the ear on
a regular basis. Put in the drops, let it sit in there for a few minutes, then
lie down on a towel to let it drip out again. Probably only a few drops every
week in each ear is good enough (nobody has done a research study on this).
It doesn’t hurt to put a few drops of clean olive oil or baby oil into each
ear every day. Swimmers often do this prior to their daily swim. However, be
sure that the oil is clean, as you don’t want to introduce bacteria. This should
not be done if you have an eardrum perforation or if you don’t know whether
or not you have a perforation.

A second method is to have one’s doctor prescribe a 60 cc bottle of Domeboro
otic and place 2 drops of this solution into their ear weekly
after showering. The Domeboro solution supposedly stimulates migration of wax out of the
canal. We don’t know of a study that proves that this is really true though.

Another method is to have your ear cleaned out by your doctor on a regular
basis. Everyone builds up wax at their own rate, but commonly people need to
come back for wax removal at 6 month or 1 year intervals.

We recommend against using cotton tipped applicators (the so-called ‘Q’ TIPS)
as well as putting other things into your ear such as hair pins. This can be
dangerous because you run the risk of breaking your ear drum (“perforation”),
as well as jamming wax deeper inside. Nonetheless, some people use Q-tips without
apparent harm. If you do use them anyway, in spite of the official recommendation
against doing so, caution is advised as well as limiting use to once per week.

See also:

• https://www-surgery.ucsd.edu/ent/DAVIDSON/Pathway/EarWax. htm
• An article about whale ear wax, also see https://www.nature.com/articles/s41467-018-07044-w”:

References:

• Bankaitis AU, Kelso S. Cerumen Management. Oaktree Products.
• Bloom S. In the battle to control cerumen, there’s progress on many fronts. Hearing Journal 68,8, 2005, 19-25
• Burkhart CN and others. In pursuit of ceruminolytic agents: a study of ear
  wax composition. Am J Otol 21:157-160, 2000
• Fairey A, Freer CB, Machin D. Ear wax and otitis media in children. Br Med
  J. Clin Res Ed 1985:291:387-8
• Grossan M. Cerumen Removal–Current Challenges. ENT journal, 77, #7, 1998,
  541-548
• Hawke M. Update on cerumen and ceruminolytics. ENT journal, Supplement #1,
  2002. 23-24
• Nader ME, Saliba I. Ototoxicity of Intratympanic Docusate Sodium and Mineral Oil in the Guinea Pig. Otolaryngol Head Neck Surg. 2011 Nov 18. [Epub ahead of print]
• Petrakis NL. Earmarks of Art History: Cerumen and Medieval Art. Am. J. Otol
  21:5-8, 2000
• Roland PS and others. randomized, placebo controlled evaluation of Cerumenex
  and Murine earwax removal products. Arch Otolaryngol HNS 2004:130: 1175-1177
• Roeser, R. J. and B. B. Ballachanda (1997). “Physiology, pathophysiology, and anthropology/epidemiology of human earcanal secretions.” J Am Acad Audiol 8(6): 391-400.
• Yoshiura, K., A. Kinoshita, T. Ishida, et al. (2006). “A SNP in the ABCC11 gene is the determinant of human earwax type.” Nat Genet38(3): 324-30.

Eardrum Injuries (for Teens) – Nemours Kidshealth

What Is a Perforated Eardrum?

A perforated eardrum is a tear or hole in the ear’s tympanic membrane (the medical name for your eardrum). A perforated eardrum is also called a ruptured eardrum.

A perforated eardrum can cause a lot of pain. It can also affect hearing, but this usually is temporary.

A tear in the eardrum can allow bacteria and other things to get into the middle ear and inner ear. This could lead to an infection that might cause more permanent hearing damage.

Most perforated eardrums heal in a few days to weeks. If they don’t heal, sometimes doctors do a surgery to repair the hole.

How Does the Eardrum Work?

The eardrum is a thin piece of skin-like tissue that’s stretched tight — like a drum — across the opening between the ear canal and the middle ear.

The outer ear funnels sound waves into the ear canal that hit the eardrum and make it vibrate. The middle ear and inner ear change the vibrations to signals that the brain senses as sounds.

A ruptured eardrum can’t vibrate as well as it should. This can cause a hearing problem, which often is temporary.

What Causes a Perforated Eardrum?

Things that can cause perforated eardrums include:

• Cotton swabs or other cleaning tools. These can poke through the eardrum.
• Sudden pressure changes (barotraumas). This might happen when flying in an airplane, driving on a mountain road, or scuba diving.
• Loud noises (acoustic trauma). Really loud noises, like an explosion or listening to loud music, can make sound waves that are strong enough to damage the eardrum. Loud noise also can cause temporary or permanent damage to the cochlea.
• Head trauma. A direct blow to the ear or a severe head injury from something like a car accident can fracture (break) the skull bone and tear the eardrum.
• Direct trauma to the pinna and outer ear canal. A slap on the ear with an open hand or other things that put pressure on the ear can tear the eardrum.
• Ear infections. An infection of the middle ear or inner ear can cause pus or fluid to build up behind the eardrum. This can make the eardrum burst.

What Are the Signs & Symptoms of a Perforated Eardrum?

The first sign of a perforated eardrum is usually pain, which may increase for a time before suddenly decreasing. Someone also might notice:

• drainage from the ear that can be clear, pus-like, or bloody
• hearing loss
• ringing or buzzing in the ear (tinnitus)
• dizziness or vertigo (a feeling that the room is spinning) that can cause nausea
• weakness in the muscles of the face

Talk to a parent or call a doctor right away if you have any symptoms of a perforated eardrum. You should also see a doctor if you continue to have symptoms after being treated for a perforated eardrum. Even though most perforations heal on their own, you want to make sure any hearing loss you is temporary.

Go to the emergency room right away if you have severe symptoms, such as:

• bloody discharge from your ear
• extreme pain
• total hearing loss in one ear
• dizziness that causes vomiting

How Are Perforated Eardrums Diagnosed?

A doctor will most likely:

• examine your ear canal with a lighted instrument called an otoscope
• do an audiology exam to see how well you hear at difference pitches and volumes
• take a sample of fluid from the ear to test for infection

How Are Perforated Eardrums Treated?

Usually, a perforated eardrum will heal on its own within a few weeks. While the eardrum is healing, your doctor might suggest:

• taking over-the-counter pain relievers
• using antibiotics to prevent infections or treat any existing infections (these could be given as a pill or as ear drops)

While your eardrum heals:

• Don’t use over-the-counter ear drops unless your doctor tells you to. If there is a hole in the eardrum, some kinds of ear drops can get into the middle ear or cochlea and cause problems.
• Avoid getting water inside the ear canal. Your doctor might recommend that you keep your ear dry during water activities to prevent infection. Gently place a waterproof earplug or cotton ball coated with petroleum jelly in your ear when you shower or take a bath.
• Don’t clean your ear or forcefully blow your nose. Wait until the tear in your eardrum is completely healed.

If your eardrum doesn’t heal on its own, an ear-nose-throat (ENT) specialist may recommend surgery to place an eardrum patch. The doctor puts a paper patch over the hole after applying a special medicine to make the tear heal. Doctors may need to do this procedure a few times until the eardrum is fully healed.

If the eardrum patch doesn’t work, the ENT specialist might do a surgery known as a tympanoplasty. The surgeon will attach a small patch of your own tissue or use man-made material to cover the hole in your eardrum.

Can Perforated Eardrums Be Prevented?

Sometimes a perforated eardrum is caused by an infection and isn’t preventable. But many eardrum perforations are preventable.

To make the chances of a rupture less likely:

• Try to avoid flying on airplanes if you have a cold or sinus infection. If you have to fly, chew gum during takeoff and landing. You can also try to equalize the pressure in your ears by yawning or swallowing.
• Get lessons if you plan to go scuba diving. Make sure you learn how to equalize the pressure in your ears. Don’t scuba dive if you have an ear infection, sinus infection, or cold.
• Never stick anything in your ear, even to clean it. If you get something stuck in your ear, see a health care provider to take it out, so you don’t hurt your ear.
• Call your doctor right away if you notice any signs of an ear infection.

90,000 Vertigo Clinic

Our clinic for the treatment of vertigo provides services for the diagnosis and treatment of patients with dysfunction of the balance organ in the inner ear and the nerves of the vestibular apparatus. The symptoms of the disease are felt as dizziness with the sensation of riding a carousel or swimming, i.e. severe dizziness to loss of balance and falls; feelings of immersion or free fall.

Vertigo and dizziness

Vertigo is a sudden sensation of loss of balance or movement of the surrounding space in front of the eyes.You may feel that you are spinning like a carousel or that your head is spinning inward. In the first case, the patient feels that everything is spinning in front of him or his body is spinning. This usually occurs as a result of a sudden illness or disturbance of the organs of balance. Dizziness is characterized by weakness or frustration, usually caused by low blood sugar or low blood pressure in a chronic condition.

Vertigo can be observed after a long flight or travel on water, in which a person’s consciousness becomes accustomed to turbulence, which leads to the patient feeling that he is moving up and down.This feeling usually goes away after a few days. Vertigo also occurs when exposed to a very loud sound from its pressure in the inner ear, which relieves the load on the organ of balance. Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that vertigo can cause and is characterized by brief episodes of mild to severe vertigo when head position changes.

Diseases that can cause vertigo and deafness

Vertigo may result from:

1. Otitis media – inflammation or infection of the middle ear.
2. Eustachian tube dysfunction (EST) or auditory tube dysfunction: Occurs when the tube cannot open when swallowing or yawning.
3. Internal otitis media – inflammation of the labyrinth of the inner ear: The primary symptoms of internal otitis media are vertigo, accompanied by hearing loss and tinnitus.
4. Head Injury: Refers to injuries that can affect the inner ear.
5. Meniere’s disease: characterized by episodes of dizziness and tinnitus and usually unilateral hearing impairment.
6. Positional vertigo: Benign paroxysmal positional vertigo (BPPV) (sometimes called DPV) is the most common cause of vertigo attacks. This group of patients suffers from vertebrobasilar insufficiency (VBI) or vertebrobasilar ischemia, which leads to the development of short-term symptoms of decreased blood supply in the vertebrobasilar area of ​​the brain.
7. Degenerative changes or disorders in the central nervous system (CNS): Alzheimer’s disease, Parkinson’s disease or senile dementia.
8. Acute peripheral vestibulopathy: sudden, persistent dysfunction of the peripheral vestibular system against a background of nausea, vomiting and vertigo. Vertigo usually lasts 2 weeks.
9. Acoustic neuroma: (also known as auditory neuroma, auditory neurilemoma, or acoustic schwannoma) is a benign, usually slow-growing tumor mass that develops in the vestibular and auditory nerves.
10. Other syndromes of dysfunction of the central nervous system or brain: physical illness, diabetes mellitus, high blood pressure, infectious diseases, kidney disease, heart disease, thyroid dysfunction.

Given the variety of reasons, many factors must be taken into account when diagnosing, including:

• The patient’s history of vertigo (its type and duration of seizures)
• Physical examination

Special diagnostic techniques

A. Hearing examination

1. Audiometry: to determine the speed of response of hearing
2. Tympanometry and acoustic reflex to test middle ear function
3. Bekesy – automatic audiometry

B.Examination of the vestibular apparatus

1. Posturography
2. Caloric test
3. Positioning Test
4. VNG

C. Physiological examination

1. Brain stem electrical reaction audiometry (BERA – ABR)

Summary

Vertigo – a sudden feeling of loss of balance and movement of objects around you. Feeling like you are spinning on a carousel or dizzy inside.There are many reasons for the development of this condition, so if you suffer from vertigo, you need to consult with a specialist to find out the cause and treatment.

90,000 types and treatments. Advice from a DOCTOR of the Medical Center MedFarm Ussuriysk

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10.09.2019 00:00

The disease of otitis media refers to ENT diseases and is an inflammation of the ear. You can suspect otitis media by the following symptoms: pain and noise appear in the ear, the temperature rises, the sense of smell and sleep are disturbed, dizziness and weakness appear, and hearing deteriorates.Epistaxis may occur and pus may drain from the ear. Otitis pain is throbbing, aching, or shooting. They intensify during swallowing, sneezing or coughing, spreading to different parts of the head and teeth.

The structure of our ear.

The ear consists of three parts:
– of the outer ear. The external ear includes the auricle, external auditory canal and eardrum;
– of the middle ear, which is necessary for the conduction of sound.It consists of the tympanic cavity and the auditory (Eustachian) tube;
– of the inner ear is a hollow bone formation in the temporal bone, which consists of bony canals and a cavity with the receptor apparatus of the vestibular and auditory analyzers.

First, the sound enters the ear canal and travels along the eardrum. Sound causes the membrane to vibrate, transferring sound to the ossicles in the middle ear and then to the inner ear. At the end, the sound travels along the nerves to the brain.

Types of otitis media.

The inflammatory process can affect the outer, middle or inner ear, depending on which the disease is called: otitis externa, middle and inner.

Otitis externa.

The cause of otitis externa is a bacterial or fungal infection that leads to inflammation of the external auditory canal or the skin of the auricle. Infection gets into the ear when sharp, dirty objects are used to clean the ears, damage to the skin of the ear canal, insect bites, frostbite and burns.
The symptom of otitis externa is itching and pain when pressing on the inflamed area of ​​the ear.

Otitis media.

Of the three types of otitis media, otitis media is the most common. In this case, otitis media fills the ear cavity with infected fluid. Infectious diseases (tonsillitis, ARVI, influenza, measles, etc.) and dirty water getting into the ear can lead to ear inflammation.

In a healthy ear, fluid from the middle ear leaves through the Eustachian tube, which connects the nasopharynx and the tympanic cavity.And in inflammatory processes that cause swelling of the mucous membrane of the nasal cavity or nasopharynx, the lumen of the Eustachian tube is blocked, making it difficult for fluid to drain. Fluid begins to accumulate in the tympanic cavity, causing pain and temporary hearing loss.

The inflammatory process leads to the secretion of ichor, pus, mucus from the ear canal, flowing out through the rupture in the eardrum. If you carry out timely treatment and do not lead to complications, then the gap in the membrane overgrows over time, and hearing is restored.

Adenoids, a deviated nasal septum or a foreign body can lead to blockage of the Eustachian tube.

At best, pus breaks out. However, sometimes pus cannot escape and bursts into the cranial cavity, leading to meningitis, brain abscess, or mastoiditis.

Children are more prone to otitis media, which is explained by the age characteristics of the Eustachian tube of this period. For this reason, nasal discharge in children easily gets into the middle ear, leading to inflammation in the ear.Therefore, in children, a runny nose often leads to otitis media.

If the child has a runny nose, as well as anxiety, pain in the parotid region, headache, then you should consult an ENT doctor. It happens that otitis media proceeds without pain, which leads to their untimely identification and treatment, and then to hearing loss.

Internal otitis media.

Untreated otitis media or a severe general infectious disease can lead to internal otitis media.Internal otitis media is much less common than others, but at the same time they are more dangerous.

Treatment of otitis media.

As with most diseases, otitis media requires bed rest. In addition, experts prescribe anti-inflammatory drugs and antibiotic therapy. When the temperature is high, antipyretic drugs will be added.

To reduce swelling of the mucous membrane of the nasal cavity and nasopharynx, vasoconstrictor nasal drops are prescribed, and to relieve severe pain in the ear – drops with anesthesia.In addition, rinsing with antiseptic solutions is carried out, warming compresses are made, physiotherapy procedures are carried out.

If the healing process is greatly delayed, then doctors may resort to a targeted dissection of the wall of the tympanic membrane in order to allow the accumulated pus to escape outside, and not into the inner region of the head. This procedure leads to a rapid improvement in the patient’s condition.
The main course of treatment ends with restorative and resorption therapy.Also, according to the doctor’s prescription, treatment of otitis media with folk remedies can be added.

Source

90,000 Do you feel dizzy? Check your ears! | Healthy life | Health

Let’s figure out why such violations occur.

Our expert – Head of the Scientific and Clinical Department of Otoneurology and Vestibulology of the Federal State Budgetary Institution NKTSO FMBA of Russia, Candidate of Medical Sciences, Otoneurologist Olga Zaitseva.

In the maze

The vestibular apparatus is an organ of balance that determines the position of our body in space.It is located in the inner ear and has a rather complex structure, similar to a labyrinth, filled with liquid and lined with special cells – vestibular receptors, which are covered with a membrane. Otoliths – small calcium crystals – are formed on the membrane surface. Under a certain set of circumstances, otoliths can “jump” over their natural defenses and begin to move freely in the inner ear fluid. And then dizziness arises.

There is another theory according to which hormonal disruptions cause disturbances in calcium metabolism, and crystals of calcium carbonate float freely in the fluid of the inner ear, causing anxiety to patients.

Experts call this type of vertigo “benign paroxysmal positional vertigo” (BPPV). The term BPPV ideally characterizes the disease itself: “benign” means no health consequences and possible self-healing (over time, calcium particles can dissolve in the fluid of the inner ear or move into place – and the dizziness will disappear by itself), “paroxysmal” means that the symptoms are paroxysmal in nature, “positional” indicates the occurrence of dizziness when changing the position of the body or head, or rather, the vestibular apparatus in space, and the word “dizziness” characterizes the main symptom of the disease.

Like a carousel

The main symptom of BPPV is a short (usually within 1 minute) rotational dizziness. It seems to a person that the surrounding objects revolve around him, sometimes there is nausea and vomiting.

Usually, dizziness with BPPV occurs when the position of the head in space changes (getting up from a lying position, bending forward, turning in bed, throwing the head back).

The attack begins suddenly and has no precursors.Therefore, it is impossible to prevent the first attack. However, if an episode of BPPV occurs, try to remember what preceded it. In order to try to avoid movements that provoke dizziness in the future.

During an attack of BPPV, it is advisable to behave calmly, not to lie down, but to take an upright position. The attack will stop on its own: as a rule, within a few seconds – 1 minute. After that, you need to see a doctor to clarify the diagnosis.

How will we treat?

If you suspect BPPV, it is best to consult an otoneurologist.These doctors have special techniques for detecting the disease and can conduct a competent examination by doing provocative tests for BPPV. During them, the doctor changes the position of the patient’s body in a special way in order to understand whether any movements cause an attack of dizziness.

In some cases, an ENT, neurologist, general practitioner, or general practitioner may perform such tests if the physician is skilled.

Treatment for BPPV consists in carrying out the so-called treatment and rehabilitation maneuvers.As with provocative tests, the doctor moves the patient’s head, but at the same time pursues a different goal – not to provoke an attack, but to return the calcium crystals to their place.

Subsequently, such exercises can be performed by the patient himself, but this can be done only after consulting a specialist, because the technique and frequency of their repetitions is determined based on the situation of this particular patient.

But medical support for BPPV, as a rule, is not required.In extremely difficult situations, surgical treatment is possible, but this is extremely rare!

Ordinary life

Once having experienced an attack of BPPV, many patients are afraid that it will recur and create a number of artificial restrictions for themselves.

This is not required at all. After getting rid of BPPV, you can fly an airplane, dive, drive, go to work. By the way, the influence of occupational hazards on the occurrence of BPPV has not been established.

Some patients, on the contrary, try to train the vestibular apparatus using exercises such as bending and rotating the head (on the Internet, such exercises are often recommended for the prevention of seasickness).But, unfortunately, no exercise can prevent the onset of BPPV, and the propensity for motion sickness in transport has nothing to do with this disease. BPPV is one of the rare cases where there are no specific preventive measures. Don’t just spin in your office chair!

Removal of sulfur plugs No. 1 in Izhevsk, prices, descriptions, doctors

Sulfur plug in the ear is a fairly common situation, which is an accumulation of sulfur masses in the ear, consisting of the secretion product of special ear glands, as well as particles of dead skin cells and dust.

In case of diagnosing this problem in a patient, you should contact a specialized specialist – an otolaryngologist. The doctor will examine the ear, determine the position of the sulfur plug and its composition, and select the best way to remove it.

Removal of sulfur plug in the clinic Medservice

The most common and frequent method of removing the wax plug is by flushing the ear. The patient sits on a chair, with a sore ear to the doctor, an oilcloth is spread over his shoulder, and a tray is placed under his ear, which the patient holds on his own.For washing, a special 100 ml syringe is used – Janet’s syringe. The doctor draws warm (but not hot and not cold) water into a syringe and carefully, directing a stream of water along the upper-posterior wall of the external auditory canal (this is necessary so as not to damage the eardrum with a stream of water), flushes the sulfur masses from the external auditory canal.

The procedure can be unpleasant, especially if the cork is tight and old. It is far from always possible to wash the sulfur masses from the ear the first time.If, after three attempts, the plug is not removed, the doctor usually stops the procedure and prescribes softening drops to the patient for several days. 2-3 drops several times a day helps to loosen the tight plug, and repeated rinsing of the ear is usually successful.

The second method for removing the sulfur plug is the dry method. Usually, this is how the cork is removed from those for whom rinsing is contraindicated. At the same time, the doctor removes the sulfur masses from the ear with a special ear hook under vision control.

Readings

Most often, the sulfuric plug does not manifest itself until it completely blocks the auditory canal. In such cases, the following symptoms are possible:

• Loss or significant loss of hearing in one ear;
• foreign body sensation in the ear;
• noise in the ear;
• dizziness;
• coordination disorder;
• headache

In some cases, when the sulfur masses are located close to the tympanic membrane, it is also possible a violation of cardiac activity, due to the fact that the work of the heart is associated with the nerve endings approaching the ear.

Contraindications

Perforated otitis media are contraindications for removing the sulfur plug.

Results of procedure

After removing the sulfur plug, the doctor must examine the ear again. He needs to assess the condition of the tympanic membrane and exclude otitis media.

90,000 Causes and Drug Treatment – What to do if tinnitus and dizziness

Such neurological pathology as tinnitus and head noises in the absence of any external stimuli is the most difficult diagnostic task for a specialist.This is not an independent diagnosis, but one of the symptoms that something is wrong in the body. In order to find out what disorders in the functioning of organs and / or body systems are indicated by tinnitus, dizziness and other possible concomitant symptoms and to take appropriate measures, you should consult a doctor.

A kind of norm is a mild one-sided or two-sided noise, which the patient notes at a time when it is quiet around him. Most often it is a sound that is a consequence of blood flow in the small vessels of the inner ear – this is a natural process. Pathological noise in the ears and head, the treatment of which is a necessary measure, includes the consequences of various disorders of the middle and inner ear, diseases of the auditory nerve, intoxication of the body, etc. The patient himself may characterize such noise as hum, ringing, hissing or whistling. And this, and the severity of its manifestation – everything can be important for the diagnosis and selection of a treatment regimen!

Tinnitus is often combined with anxiety and fear, which makes the patient stressful.He cannot concentrate on anything, loses his ability to work, and in especially neglected cases he still cannot fall asleep. Over time, this can lead to depression. Do not expect disturbing symptoms to disappear by themselves – contact a specialist!

Causes of tinnitus

The most common triggers for this unpleasant symptom are:

• blockage of the ear canal – in the vast majority of cases, only on one side.It may be the result of the ingress of a foreign body – for example, an insect or a small rounded object (children can push a pea, a button, etc. into the ear) In addition, the cause of the blockage may be the ingress of water into the ear or the formation of a sulfur plug in it;
• diseases of the outer ear can also provoke noise. These include otitis media and fungal infection of the ear, or mycosis. They may also be accompanied by painful sensations in the affected organ of hearing and whitish or purulent discharge from the auditory passage.A strong, sometimes unbearable pain is also accompanied by an ear boil – purulent inflammation of soft tissues, for the treatment of which the help of a surgeon is needed;
• diseases of the middle ear – otitis media, eustachitis and mastoiditis – may also be accompanied by high fever and discharge;
• damage to the eardrum can also lead to tinnitus ;
• diseases of the inner ear – otosclerosis, which is accompanied by uncontrolled growth of the bone tissue component of the labyrinth, and labyrinthitis – inflammation triggered by an infection – are accompanied not only by tinnitus and dizziness, but also by nausea, impaired coordination and progressive hearing loss;
• all kinds of pathologies of the auditory nerve – it can be a nerve tumor, as well as neuritis and even neurosyphilis;
• disorders of the blood supply to the brain often cause noise in the ears and head, dizziness, periodic darkening in the eyes, as well as a host of other unpleasant symptoms;
• also a lack of blood supply to the brain may be a consequence of cervical osteochondrosis;
• Finally, the reasons that provoke the appearance of hum, hiss, ringing and other unpleasant sounds in the ears, not related to external factors, may be taking certain pharmaceuticals, smoking tobacco and smoking mixtures, alcohol, coffee, energy drinks abuse, overwork, prolonged stay in stress, head trauma, prolonged exposure to external noise, and old age.

Tinnitus: what to do?

Effective treatment of tinnitus and head – drugs from a pharmacy or any other means – can be selected only after diagnosis by an ENT doctor or neurologist. In our medical center, patients suffering from this extremely unpleasant symptom can be treated with an unconventional, but no less effective treatment with an osteopath or kinesiologist. The treatment techniques used by these specialists allow you to carefully regulate the activity of the organs and systems of the patient’s body, eliminating not only the manifestations of pathology, but also their very cause.

Important! Don’t try to get rid of tinnitus with self-medication! This is fraught with the progression of the disease, which manifests itself, including these symptoms, and the development of numerous complications. One of them can be a progressive hearing loss – up to and including its complete loss. Enlist the help of professionals and do not risk your health!

90,000 Topical antiseptics versus antibiotics for people with chronic suppurative otitis media

What is the purpose of this review?

The purpose of this Cochrane Review was to determine whether topical antiseptics are more effective than antibiotics in the treatment of chronic suppurative otitis media.The review authors collected and analyzed all relevant studies to answer this question.

Key Information

There is not much evidence comparing topical antiseptics with topical antibiotics. The evidence that antibiotics or topical antiseptics are more effective in reducing ear discharge is very vague, except that topical antibiotics are likely more effective than boric acid.

What was learned in this review?

Chronic suppurative otitis media (CHOS) is a prolonged (chronic) edema and infection of the middle ear, with discharge from the ear (otorrhea) through the perforated tympanic membrane (tympanic membrane). The main symptoms of HCV are discharge from the ear and hearing loss.

Antibiotics are the most commonly used treatment for chronic hepatitis B. Antibiotics can be either “topical” (which is injected into the ear canal in the form of ear drops, ointments, sprays, or creams) or “systemic” (which is taken orally or injected into a muscle or vein).Topical antiseptics (antiseptics injected directly into the ear in the form of ear drops or in powder form) are a possible treatment for CHS. Antibiotics and topical antiseptics kill or stop microorganisms that can cause infections.

Antibiotics and topical antiseptics can be used on their own or added to other treatments for HCV, such as antibiotics [for systemic use] or ear cleaning (ear toilet). In this review, it was important to consider whether there are any adverse effects from the use of antibiotics and antiseptics.Possible adverse events may include irritation of the outer ear skin, which can cause discomfort, pain, or itching. Some antibiotics and antiseptics (such as alcohol) can also be toxic to the inner ear (ototoxicity), which means they can cause permanent hearing loss (sensorineural), dizziness, or ringing in the ears (tinnitus).

What are the main findings of this review?

We found seven studies involving 935 people.We found data on four different types of topical antiseptics: acetic acid, aluminum acetate, boric acid, and povidone iodine.

Comparison of antibiotics with acetic acid, aluminum acetate or povidone iodine

It is unclear whether the use of topical or systemic antibiotics is better than acetic acid, aluminum acetate, and povidone iodine for relieving otorrhea in patients with chronic hepatitis B, since the certainty of the evidence is very low.It is impossible to determine if there are differences between groups for any other outcome.

Comparison of antibiotics with boric acid

We included two studies (532 participants) that showed that topical antibiotics (quinolones) were probably better than boric acid for resolving otorrhea when evaluating this outcome after one to two weeks. In addition, it is possible to reduce ear discomfort (pain, irritation, and bleeding) and improve hearing with topical antibiotics compared to boric acid.

How relevant is this review?

Evidence is current to April 2019.

Walls that scream: why sounds in an apartment can harm us

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Walls that scream: why sounds in an apartment can harm us

Walls who scream: why the sounds in the apartment can harm us – Real Estate RIA Novosti, 04.08.2021

Walls that scream: why sounds in an apartment can harm us

Scolding neighbors behind the wall, the roar of cars outside the window, the ticking of a clock on a curbstone are traditional sound stimuli in city apartments. However, some noises … Real Estate RIA Novosti, 08/04/2021

2019-04-26T10: 40

2019-04-26T10: 40

2021-08-04T12: 39

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Swearing neighbors behind the wall, the roar of cars outside the window, the ticking of a clock outside the window However, some noises go beyond our perception and at the same time have a much more destructive effect on our health. The RIA Real Estate website turned to experts for help to find out what sounds we really need to be afraid of and why we need to strive for absolute silence.Invisible Enemy City residents live all day in noise: cars and the subway, loud equipment, rearranging furniture at neighbors and repairing the road under the window. Even a slight noise with regular exposure will negatively affect the psyche, hearing, and the nervous system. And if the sounds are loud, even the cardiovascular or hormonal systems may suffer, says Sergey Sysoev, head of the department of independent environmental expertise of EcoStandard group. Singer and voice coach Nina Vedenina-Meerson agrees with the expert, adding that to the sounds that endanger health of our body and nervous system, include the hum of an elevator, construction noises, the sounds of cars, the noise of household appliances (such as a refrigerator or washing machine), “ticking” of bulbs, dripping water, whistling / howling of wind through the cracks.However, the interlocutor of the agency draws attention to the fact that if the same water just flows, it will have a wonderful effect on us. “Natural sounds are a good soothing for us. Our psyche responds to them with peace of mind. But if only they are not prohibitively loud,” she explains. In turn, Sysoev, among the harmful and even dangerous noises, distinguishes infrasound and night noise. “Infrasound is low frequencies up to 16 Hz, indistinguishable to human hearing, but negatively affecting health. Infrasound can be felt as vibration in the air, similar to a hum, but excess can only be detected using special equipment,” the expert explains.Infrasound comes from engineering equipment, power lines and even from busy highways, but it can also occur in natural environments, for example, during wind erosion of rocks and stones. According to the agency’s interlocutor, exceeding the permissible level of infrasound can cause a person to feel nausea, dizziness, headache. and a growing sense of fear that escalates into panic. Regular exposure to infrasound can lead to changes in blood pressure and heart rate, disruption of the vestibular functions of the brain, and even disruption of the gastrointestinal tract.People over 50 are especially susceptible to the effects of infrasound. The first effects of exposure to nighttime noise are sleep disturbance and irritability. Noise at night can also lead to high blood pressure, even if the person does not wake up, he notes. Secret knowledge about noise Irritants and harmonious sounds are universal for everyone, when it comes to people with a healthy psyche, draws attention to Nina Vedenina-Meerson. So, the murmur of water, the light chirping of birds (just light!), The noise of foliage, rain, various music, calm speech, the purr of a cat has a beneficial effect on humans.Whereas aggressive screams and growling music from behind the wall will be annoying. However, there is an important caveat. “If the psyche is shattered, anything annoys. If everything is in order, we can pass almost any sound deaf. And here is a dangerous thing: with our ears (brain) we pass sound, but the body feels negative vibrations that harm us. However,” , we can hide from external stimuli, but there is one from which we cannot escape, and it has the most direct influence on us – this is our voice, “explains the voice trainer.In this case, the voice trainer recommends to monitor your sound and try to keep your voice even, not spasmodic, but not monotonous and boring. He should be soft, at the same time confident and short. Speech should not be fast and with soft drawn-out endings, intoning up, not down – then it will be benevolent and not destructive. Not everything is so simple and with harsh, aggressive sounds. For example, in the form of noise, that is, random sound vibrations, like a neighbor’s swearing behind a wall, they cause discomfort.But in the form of music, even the most “harsh”, they can be liked. “Shut up” the source To the question “Is it necessary, in principle, to strive for maximum silence in the apartment?” experts answer unequivocally “yes”. However, you can deal with noise in different ways. If the source of the noise is quite specific and understandable, then you need to try to eliminate it. It is important to remember here that technogenic and social sources of noise are standardized in different ways, referring to different sections of the legislation, Sysoev notes. “Man-made noise from equipment, vehicles or construction sites is regulated by sanitary and hygienic standards.Loud behavior of neighbors, singing, crying children, barking dogs, music and other similar sounds, in turn, are regulated by administrative rules. In practice, this means that in the first case, it is necessary to call environmental specialists to conduct an acoustic examination, and in the second case, law enforcement agencies. Dealing with loud neighbors and drunken screams under the window is the duty of the district police officer, not environmentalists, “the agency’s interlocutor argues. The easiest way is to deal with the sources of unpleasant sound inside the apartment, which are often household appliances and lamps.They can either be replaced, or adjusted, or completely abandoned if possible. Shield and barrier If the source of external noise cannot be eliminated or corrected, then you need to protect yourself as much as possible from sound waves, reducing their penetration into the apartment to a minimum. So, when considering windows as a way to protect against street noise, the expert advises to pay attention to several important parameters. First, the correct double-glazed window must include soundproofed triplex glass. It consists of two layers of glass and a PVB film (polyvinyl butyral film) between them.Triplex glass can more than double the level of noise penetration, Zayonchkovsky notes. Secondly, the thickness of the glasses in the profile should be different. The fact is that glasses of different thickness resonate at different frequencies, so that when sound waves pass through them, there is no summation of resonances and doubling of resonance noise, whereas in the case of two or three glasses of the same thickness, resonances add up and the “noise” of the window is significant increases. Thirdly, it is better to choose glass of increased thickness (optimally 5-6 mm), since the thicker the glass, the more rigid the acoustic membrane it is and the more difficult it is for the sound wave to drive it into resonance.As for the material of the profile itself, the Ekookon expert notes its advantages both for PVC profiles and for wooden profile systems. However, at the same time, he clarifies that in reality the degree of noise protection is much more than the material of the profile (PVC or wood), influenced by the quality and quantity of sealing contours, which prevent the direct passage of the sound wave. “Let us recall the old Soviet wooden frames, where the seals and the tightness of the sash porch were not a class, and along with them there was no decent sound insulation,” says Zayonchkovsky.Voluntary “deafness” The noise in the apartment itself can be divided into at least two types – airborne, propagating through the air, and structural, propagating through the structure of the house, notes Nikolai Efimenko, commercial director of the EchoKor project. Protecting yourself from noise in urban housing is not easy and definitely not cheap. Real soundproofing solutions include building additional partitions decoupled from walls, ceilings and floors. That is, this is the construction of an isolated room in an existing room.Other solutions that do not cover the entire perimeter of the room are ineffective, emphasizes the agency’s interlocutor, while he draws attention to the fact that both sound insulation and sound absorption are needed for an apartment. “First, we need to resolve the issue of sound insulation, even at the stage of construction and repair, and then think about sound absorption, that is, about acoustic comfort,” explains Efimenko. But often apartment owners realize the need for sound insulation at the stage when the renovation is done. Then architectural acoustics comes to the rescue, namely, special sound-absorbing decorative panels, from which the sound will not repel, as from hard surfaces.For example, whole panels or design compositions can be assembled from the EchoKor panels, Efimenko points out. Sound-absorbing panels, according to the expert, can reduce the background noise level, promote speech intelligibility and at the same time decorate the apartment, which, of course, in the complex will have a positive effect on the condition To summarize, experts emphasize that it is impossible to make an apartment as quiet as in a submarine just by installing glass or installing sound-absorbing panels.”The complete (or almost complete) insulation of an apartment from external noise depends on a combination of a number of factors. In addition to the design of the windows, the material of the walls of the building also plays an important role,” says an expert at Ekookon. He explains that the transmission of sound depends on the ability of sound waves to “rock” the obstacle. Hence, the conclusion is obvious that it is more difficult to swing a heavier and more rigid material: a brick wall will better protect against sound than the walls of a frame house. This is on the one hand. On the other hand, having penetrated into the material, the sound wave behaves differently.Dense, homogeneous materials conduct sound much better than porous or fibrous structures. In addition, the degree of sound insulation is highly dependent on the frequency of the sound, and different materials behave differently. In other words, some are better at withstanding high-frequency noise, others with low-frequency noise, explains Zayonchkovsky. So here we need a comprehensive expert assessment of each specific building and the situation in an individual apartment. In particular, the quality of sound insulation is checked: when new buildings are commissioned, in case of violation of sound insulation during renovation work, as well as if residents are suspected of non-compliance with sound insulation standards from neighbors from above, Sysoev from EcoStandard group points out.In this case, in order to conduct acoustic studies, the neighbor from above should not be against checking and agree to let metering specialists into his apartment. Of course, he has every right not to do this, but this does not prevent the neighbor from below from applying for an examination only on the basis of his suspicions.

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Swearing from neighbors behind the wall, the roar of car engines outside the window, the ticking of a clock on a curbstone are traditional sound stimuli in city apartments. However, some noises go beyond our perception and at the same time have a much more destructive effect on our health.The RIA Real Estate website turned to experts for help to find out what sounds we really need to be afraid of and why we need to strive for absolute silence.

Invisible enemy

City residents live all day in noise: cars and the subway, loud equipment, rearranging furniture at neighbors and repairing the road under the window. Even a slight noise with regular exposure will negatively affect the psyche, hearing, and the nervous system. And if the sounds are loud, then even the cardiovascular or hormonal systems may suffer, says Sergey Sysoev, head of the department of independent environmental expertise of EcoStandard group.

The singer and voice coach Nina Vedenina-Meerson agrees with the expert, adding that the sounds that endanger the health of our body and the nervous system include the hum of an elevator, construction noises, the sounds of cars, the noise of household appliances (like a refrigerator or washing machine ), “ticking” of bulbs, dripping water, whistling / howling of wind through the cracks. However, the interlocutor of the agency draws attention to the fact that if the same water just flows, it will have a wonderful effect on us.”Natural sounds are a good soothing for us. Our psyche responds to them with peace of mind. But if only they are not prohibitively loud,” she explains.

October 1, 2018, 12:07

Don’t stomp like elephants! How to protect your apartment from unnecessary noise Neighbors stomp, drop things on the floor and listen to loud music, and their children scream and run loudly right overhead. All these problems are well known to almost any resident of an apartment building. The site “RIA Real Estate” decided to talk about how you can solve the problem of soundproofing in an apartment.

In turn, Sysoev, among the harmful and even dangerous noises, distinguishes infrasound and night noise.

“Infrasound is low frequencies up to 16 Hz, indistinguishable to human hearing, but negatively affecting health. Infrasound can be felt as vibration in the air, similar to a hum, but excess can only be detected using special equipment,” the expert explains. Infrasound comes from engineering equipment, power lines and even from busy highways, but it can also occur in natural environments, for example, during wind erosion of rocks and stones.

According to the interlocutor of the agency, exceeding the permissible level of infrasound can cause a person to feel nausea, dizziness, headache and a growing feeling of fear, which turns into panic. Regular exposure to infrasound can lead to changes in blood pressure and heart rate, disruption of the vestibular functions of the brain, and even disruption of the gastrointestinal tract. People over 50 are especially susceptible to the effects of infrasound.

“As for the noises at night, their harm is caused by the natural property of a person to react more strongly to sounds at night.Allowed noise levels for day and night differ for a reason – at night and with closed eyes, hearing sharpens compared to wakefulness. That is why at night we are more likely to wake up sharply from a sound that would seem less loud to us during the day, “says Sysoev.

Sergey Sysoev

Head of the Department of Independent Environmental Expertise EcoStandard group

The first consequences of exposure to night noise are sleep disturbance and irritability. noise can also lead to high blood pressure, even if the person does not wake up, he notes.

Secret knowledge about noise

Irritants and harmonious sounds are universal for everyone, when it comes to people with a healthy psyche, draws attention to Nina Vedenina-Meerson.

So, the murmur of water, the light chirping of birds (just light!), The noise of foliage, rain, various music, calm speech, the purr of a cat has a beneficial effect on humans. Whereas aggressive screams and growling music from behind the wall will be annoying.

However, there is an important nuance.”If the psyche is shattered, anything annoys. If everything is in order, we can pass almost any sound deaf. And here is a dangerous thing: with our ears (brain) we pass sound, but the body feels negative vibrations that harm us. However,” , we can hide from external stimuli, but there is one from which we cannot escape, and it has the most direct influence on us – this is our voice, “explains the voice trainer.

“How does the voice affect us? Being in the same living / working space with a person who does not correctly command his voice is detrimental to our psyche and health.After all, these are the same vibrations. For example, in female voices, creak, squeak, squeal, choking, aggressive rudeness often prevail. With such a voice, they usually press, scold, whine, swear, in general, push them away, “Vedenina-Meerson says.

Nina Vedenina-Meerson

Singer, voice coach

so that the voice is even, not spasmodic, but not monotonous and boring. It should be soft, at the same time confident and low.Speech should not be fast and with soft drawn-out endings, intoning up, not down – then it will be benevolent and not destructive.

Not everything is so simple and with harsh, aggressive sounds. For example, in the form of noise, that is, random sound vibrations, like a neighbor’s swearing behind a wall, they cause discomfort. But in the form of music, even the most “harsh”, they can be liked.

“The fact is that the neighbors are screaming with natural aggression, and we listen, no matter how someone kills whom.Music, on the other hand, is, first of all, the arrangement with musical instruments. We understand that this is an artificially created aggression, that is, in this case, it is such an art – to aggro. Therefore, if the decibels are within the normal range, and we will be comfortable, “explains Vedenina-Meerson.

Nina Vedenina-Meerson

Singer, voice coach silence in the apartment? “The experts unequivocally answer” yes “.However, you can deal with noise in different ways.

If the source of the noise is quite specific and understandable, then you need to try to eliminate it. It is important to remember here that technogenic and social sources of noise are standardized in different ways, referring to different sections of the legislation, Sysoev notes.

“Technogenic noise from equipment, vehicles or construction sites is regulated by sanitary and hygienic standards. Loud behavior of neighbors, singing, crying children, barking dogs, music and other similar sounds, in turn, are regulated by administrative regulations.In practice, this means that in the first case, it is necessary to call environmental specialists to conduct an acoustic examination, and in the second case, law enforcement agencies. Dealing with loud neighbors and drunken screams under the window is the duty of the district police officer, not environmentalists, “the agency’s interlocutor argues.

The easiest way to deal with the sources of unpleasant sound inside the apartment, which are often household appliances and lamps. They can either be replaced or adjusted , or completely abandon them if possible.

Shield and barrier

If the source of external noise cannot be eliminated or corrected, then you need to protect yourself as much as possible from sound waves, reducing their penetration into the apartment to a minimum.

It is important to note here that noise protection consists of two different physical concepts: “sound insulation” and “sound absorption”. “Sound insulation is a decrease in the level of sound pressure when a sound wave passes through a material. Sound absorption is a decrease in the energy of a reflected sound wave when it interacts with an obstacle.Both parameters are very important for the final overall feeling of noise protection, “explains Ilya Zayonchkovsky, a technical specialist of the Ecookna group of companies. pay attention to several important parameters: First, the correct insulating glass unit must include soundproof triplex glass, which consists of two layers of glass and a PVB film (polyvinyl butyral film) between them.Triplex glass can more than double the level of noise penetration, Zayonchkovsky notes.

Secondly, the thickness of the glass in the profile must be different. The fact is that glasses of different thickness resonate at different frequencies, so that when sound waves pass through them, there is no summation of resonances and doubling of resonance noise, whereas in the case of two or three glasses of the same thickness, resonances add up and the “noise” of the window is significant increases.

Thirdly, it is better to choose glass of increased thickness (optimally 5-6 mm), since the thicker the glass, the more rigid the acoustic membrane it is and the more difficult it is for the sound wave to drive it into resonance.

November 10, 2017, 13:53

Window on the road: how to live comfortably in an apartment with windows on the highway Noise, dust, annoying light – all this will be provided to the owners of apartments, whose windows overlook the highway. However, this does not mean at all that life in such premises will be uncomfortable. The experts told the readers of the RIA Real Estate website about the technologies that come to the rescue in this case.

As for the material of the profile itself, the Ekookon expert notes its advantages in both PVC profiles and wooden profile systems.However, at the same time, he clarifies that in reality the degree of noise protection is much more than the material of the profile (PVC or wood), influenced by the quality and quantity of sealing contours, which prevent the direct passage of the sound wave. “Let us recall the old Soviet wooden frames, where the seals and the tightness of the sash porch were not a class, and along with them there was no decent sound insulation,” says Zayonchkovsky.

Voluntary “deafness”

Noise in the apartment itself can be divided into at least two types – airborne, propagating through the air, and structural, propagating through the structure of the house, says Nikolay Efimenko, commercial director of the EchoKor project.

Protecting yourself from noise in urban housing is not easy and definitely not cheap. Real soundproofing solutions include building additional partitions decoupled from walls, ceilings and floors. That is, this is the construction of an isolated room in an existing room. Other solutions that do not cover the entire perimeter of the premises are ineffective, the agency’s interlocutor emphasizes.

At the same time, he draws attention to the fact that both sound insulation and sound absorption are needed for an apartment. “First, we need to resolve the issue of sound insulation, even at the stage of construction and repair, and then think about sound absorption, that is, about acoustic comfort,” explains Efimenko.

But often apartment owners realize the need for sound insulation at the stage when the renovation is done. Then architectural acoustics comes to the rescue, namely, special sound-absorbing decorative panels, from which the sound will not repel, as from hard surfaces. For example, whole panels or design compositions can be assembled from the EchoKor panels, Efimenko points out.

Sound-absorbing panels, according to the expert, can reduce the level of background noise, promote speech intelligibility and at the same time decorate the apartment, which, of course, in the complex will have a positive effect on the state of the nervous system of the household.

Of course, it is extremely difficult to independently choose the optimal sound insulation or sound absorption system for a particular apartment. In this matter, it is better to contact specialists. For these purposes, you can visit specialized exhibitions. So, from 15 to 19 May in Moscow in the Central Exhibition Hall “Manezh” (Manezhnaya Square, 1) will be held an international exhibition of architecture and design “ARCH Moscow”, where you can communicate with architects, designers and engineers.

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Silence is a delicate thing

Summing up, experts emphasize that it will not be possible to make an apartment as quiet as in a submarine just by installing glass or installing sound-absorbing panels.

“Complete (or almost complete) insulation of an apartment from external noise depends on a combination of a number of factors. In addition to the design of the windows, the material of the walls of the building also plays an important role,” says the Ekookon expert.

He explains that the transmission of sound depends on the ability of the sound wave to “rock” the obstacle. Hence, the conclusion is obvious that it is more difficult to swing a heavier and more rigid material: a brick wall will better protect against sound than the walls of a frame house. This is on the one hand.On the other hand, having penetrated into the material, the sound wave behaves differently. Dense, homogeneous materials conduct sound much better than porous or fibrous structures. In addition, the degree of sound insulation is highly dependent on the frequency of the sound, and different materials behave differently. In other words, some are better at withstanding high-frequency noise, others with low-frequency noise, explains Zayonchkovsky.

So here we need a comprehensive expert assessment of each specific building and the situation in an individual apartment.In particular, the quality of sound insulation is checked: when new buildings are commissioned, in case of violation of sound insulation during renovation work, as well as if residents are suspected of non-compliance with sound insulation standards from neighbors from above, Sysoev from EcoStandard group points out.

“Sometimes during repairs, residents decide to add heights to the ceilings in the apartment due to what they think are” extra “layers of the floor – with sand or sawdust. Indeed, removing them, you can win 10-20 cm, but in this case, the floor covering is laid directly on concrete, without any sound-absorbing layers.Each step on such a floor will be clearly and loudly heard by the neighbors below, “Sysoev gives an example.

Sergey Sysoev

Head of the Department of Independent Environmental Expertise EcoStandard group

Of course, he has every right not to do this, but this does not prevent the neighbor from below from applying for an examination only on the basis of his suspicions.