Vestibular Assessment & Balance Rehabilitation

The Balance System

In order for us to maintain balance, the brain gathers information from the eyes and vestibular system and combines this with what is felt through our joints, muscles and pressure sensors throughout the body. Our vestibular systems are situated within each inner ear and their function is to detect movement and where we are in space. Each vestibular system consists of three fluid-filled tubes called semicircular canals and two otolith organs. Each of these canals are aligned at different angles to each other and connected to the otolith organs enabling them to detect movement in any direction. As you move your head, the fluid within these canals moves, sending information to the brain about how fast and how far you have moved.

What is Dizziness?

The word dizziness is used to describe any feeling of unbalance. This can range from a severe spinning sensation called vertigo, to mild unsteadiness or light-headedness. Dizziness occurs when the information gathered from the balance system disagrees with what the brain recognises as normal. There can be many reasons for this

If you are concerned about any dizziness or imbalance, please see your GP who can refer you to the Ear, Nose and Throat (ENT) department, who can arrange any other investigations that might be necessary. This may include a referral to Audiology for a further assessment and to see what can be done to help.

I have been referred to Audiology, what to expect?

The service provides a comprehensive vestibular assessment and balance rehabilitation service for individuals who have been referred to the Audiology Department following an ENT consultation.

Vestibular Assessment - All vestibular assessments are carried out at Darlington Memorial Hospital by our specialised vestibular assessment team.

The vestibular assessment can take approximately 90 minutes to complete. During the assessment you may be instructed to look at lights and move your head and body into various different positions. Part of the test may require some warm and cool air (caloric test) to be delivered into your ear canals to evaluate the function of each balance organ. You may be asked to wear some goggles containing infrared cameras (VNG) which will enable us to record your eye movement during each part of the assessment. We may also test all 6 semicircular canals with the vHIT system and the otolith organs with the VEMP system.

The results of the assessment will be analysed and put into a report for your ENT specialist, along with any concerns that may have been identified. If appropriate, the specialist audiologist may discuss some balance rehabilitation techniques and/or make an appropriate referral for some balance management. The results of the assessment will be sent back to your ENT specialist for review in their ENT clinic.

Balance Rehabilitation - We offer balance rehabilitation at University Hospital North Durham and Darlington Memorial Hospital. Balance rehabilitation is a programme of rehabilitation which includes the administration of a set of graduated and customized exercises. It may also, where appropriate, include additional components such as education, breathing and relaxation exercises, counselling and gentle aerobic activity.

Other factors may also be addressed to optimise rehabilitation, such as management of anxiety and avoidance behaviours, which may require onward referral, as well as recognising abnormalities in posture, gait, joint range of motion and general physical conditioning, which may also require input from a physiotherapist or other suitable clinician as needed.

We have developed close links with the falls team, physiotherapy, social services, local support groups and many more external rehabilitation services and further information can be given as required.

see the useful contacts section for further information and local contacts