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When we evaluate you, we test you by putting your head in a position that recreates your symptoms while examining your eyes for the tell-tale rapid, involuntary movement of the eyes called nystagmus. A balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating. Three structures of the labyrinth, the semicircular canals, let us know when we are in a rotary (circular) motion. Movement of fluid in the semicircular canals signals the brain about the direction and speed of rotation of the head--for example, whether we are nodding our head up and down or looking from right to left. The balance system works with the visual and skeletal systems (the muscles and joints and their sensors) to maintain orientation or balance. Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic.
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. Benign Paroxysmal Positional Vertigo (BPPV)--a brief, intense sensation of vertigo that occurs because of a specific positional change of the head. Labyrinthitis--an infection or inflammation of the inner ear causing dizziness and loss of balance. 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. The primary physician may request the opinion of an otolaryngologist to help evaluate a balance problem. 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. Another treatment option includes balance retraining exercises (vestibular rehabilitation). You can take the following steps that may be helpful to your physician in determining a diagnosis and treatment plan. The movement of a loose otolith is similar to when you shake one of those snow-scenes in a lucite globe.
Barry Castaneda treats disoders or the Ear,Nose and Throat for adult and pediatric patients.


An organ in our inner ear, the labyrinth, is an important part of our vestibular (balance) system.
For example, visual signals are sent to the brain about the body's position in relation to its surroundings. 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. An individual may experience BPPV when rolling over to the left or right upon getting out of bed in the morning, or when looking up for an object on a high shelf. In this test, each ear is flushed with warm and then cool water, usually one ear at a time; the amount of nystagmus resulting is measured. 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. The exercises include movements of the head and body specifically developed for the patient. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture.
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. Rotation of the head causes a flow of fluid, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. These signals are processed by the brain, and compared to information from the vestibular and the skeletal systems.
The symptoms may appear and disappear over short time periods or may last for a longer period of time. 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). The cause of BPPV is not known, although it may be caused by an inner ear infection, head injury, or aging. 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. Individual treatment will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests.


These systems, along with the brain and the nervous system, can be the source of balance problems. The semicircular canals and the visual and skeletal systems have specific functions that determine an individual's orientation. An example of interaction between the visual and vestibular systems is called the vestibular-ocular reflex. Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort. The physician may require tests to assess the cause and extent of the disruption of balance. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body. Systemic streptomycin (given by injection) and topical gentamicin (given directly to the inner ear) are useful for their ability to affect the hair cells of the balance system.
The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ). These are called the otolithic organs and are responsible for detecting linear acceleration, or movement in a straight line. The nystagmus (an involuntary rhythmic eye movement) that occurs when a person is spun around and then suddenly stops is an example of a vestibular-ocular reflex. The vestibular system works with the visual system to keep objects in focus when the head is moving.
The hair cells of the otolithic organs are blanketed with a jelly-like layer studded with tiny calcium stones called otoconia. When the head is tilted or the body position is changed with respect to gravity, the displacement of the stones causes the hair cells to bend.



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