What Are Balance-Related Hearing Tests?

Fall along the Wasatch Front pulls a lot of people back onto the foothill trails once the summer heat finally breaks. Maybe you spend a Saturday morning on a stretch of the Bonneville Shoreline Trail, with fall color starting to show across the foothills.

The ground is loose and rocky in spots, so you’re used to watching your footing. What feels different is when you turn your head to take in the view and the trail seems to tilt for a second. You steady yourself, keep walking and figure it was nothing.

Balance depends on your eyes, your muscles and a small system inside your inner ear. That inner ear system sits right next to the parts that handle hearing, so trouble in one can show up in the other.

Brief dizziness, a sense of the ground shifting or trouble steadying yourself after a quick turn can all point back to it. Those moments are easy to write off as tired legs or a bad night’s sleep. When they keep coming back, though, they deserve more than a shrug.

How Your Inner Ear Handles Hearing and Balance

Hearing and balance seem like two totally different things, but they both rely on your inner ear. One part picks up sound, and another keeps track of how your head is moving and which way it’s facing. Your brain puts that together with what your eyes and muscles are telling it.

The balance part is called the vestibular system. It has tiny canals filled with fluid that react every time you turn your head, bend over or change direction. Those signals help keep your vision steady and let your brain know which way is up.

Most of the time you don’t think about it at all. You only notice it when something’s off, like when a quick look over your shoulder on a rocky trail leaves you feeling wobbly. Because the hearing and balance parts are so close together, dizziness and hearing changes sometimes show up at the same time.

What Dizziness Can Feel Like

When people hear the word vertigo, they usually think of the room spinning. Balance problems aren’t always that obvious, though. You might feel pulled to one side, wobble in the dark or feel briefly turned around after a quick turn of your head.

Watch for things like:

• The room spinning or seeming to shift
• Feeling shaky when you turn fast
• Having a hard time walking when it’s dark
• Blurry vision when you’re moving
• Ringing or muffled hearing that comes with the dizziness

Preparing for Your Balance and Hearing Appointment

A little preparation makes the appointment easier. Wear comfortable clothes and shoes you feel steady walking in, especially if your evaluation includes standing or movement tests. Bring an updated medication list and any notes you have made about when your symptoms occur.

Your clinic may also give you specific instructions about food, caffeine, alcohol or medications before vestibular testing. Follow the directions from your local audiologist rather than changing anything on your own. Never stop a prescription for testing unless the doctor who prescribed it has told you how to do so safely.

It is also worth asking whether you should arrange a ride home. Some vestibular tests temporarily bring on the same dizziness you have been experiencing. Knowing that ahead of time saves you from having to make that decision after the appointment.

What Happens During a Vestibular Evaluation

A vestibular evaluation usually starts with a conversation about what you have been feeling. Your audiologist will ask what the dizziness feels like, when it happens and whether certain movements seem to trigger it.

From there, the testing depends on your symptoms. Some people need eye movement testing, while others have positional testing, rotary chair testing or other vestibular measures. There is no single group of tests that every patient receives.

Several of these tests look at how your eyes respond when your head or body moves. Your inner ear helps keep your vision steady while you are in motion. Those eye movements give your audiologist useful information about how the balance system is responding.

How VNG Testing Looks at Eye Movements

Videonystagmography, or VNG, uses goggles with small cameras to record your eye movements. During the test, you might follow a moving target, change head positions or lie in different positions while the cameras track your response.

Some VNG testing also uses warm or cool air or water in the ear canal. This creates a predictable reaction in the balance system and lets your audiologist compare how each side responds. Not every patient needs every part of the test.

VNG does not simply tell you that one ear is the problem. Your audiologist looks at the results alongside your symptoms and any other testing. Together, those pieces help show whether the vestibular system is involved.

How the Rotary Chair Test Works

For this test, you sit comfortably in a chair that moves slowly while you wear goggles that track your eye movements. The motion is gentle and controlled.

The reason for the test is simple. When your head moves, your inner ear helps your eyes stay steady. Watching how your eyes respond gives your audiologist another way to see how your balance system is working.

Your inner ears normally trigger eye movements that help keep your vision steady when your head turns. The rotary chair test measures that reflex under different movement conditions. It can give your audiologist more information about how both sides of the vestibular system are responding.

Some people feel a little dizzy during or shortly after the movement. Preparation instructions vary by clinic, so follow whatever directions your audiologist gives you before the appointment.

Testing Stability With Posturography

Posturography looks at what your body does to stay upright when the surface beneath you changes. You stand on a special platform while sensors measure the small shifts you make to keep your balance. Depending on the test, the platform or visual surroundings may move to make your balance system work a little harder.

You are supported during the test, so you are not simply left standing on an unstable surface. A safety harness is often used to prevent a fall while still allowing your body to respond naturally. The test gives your audiologist information about how you use input from your eyes, inner ears and the rest of your body to stay steady.

Those results become more useful when they match something you have noticed outside the clinic. Posturography helps show which balance cues your body relies on most in those situations.

Why Your Health History Matters During Balance Testing

Before testing starts, your audiologist will want to know more than when you first felt dizzy. Previous illnesses, head injuries, ear problems and other health conditions can all add useful context.

Your medications and supplements also matter because some affect dizziness, alertness or balance. Be ready to talk about details such as:

• Past head injuries, concussions or ear infections
• Conditions such as diabetes or cardiovascular problems
• Prescription medications and supplements you currently take
• When dizziness happens and what you are doing when it starts

Connecting Your Test Results to What You Feel Every Day

Test results are most useful when they help explain what has been happening outside the clinic. The results do not always point to one simple cause, but they help narrow down what deserves attention next.

You might finally understand why walking in the dark feels harder, why quick turns bother you or why certain movements leave you disoriented. Your audiologist can explain what the testing shows and whether another medical professional should be involved.

The next step depends on what the evaluation finds. Some people need additional testing, while others may be referred for vestibular rehabilitation or medical evaluation. The recommendations should match the problem found rather than following the same plan for every person.

Making Daily Movement Feel Safer

Balance trouble has a way of turning ordinary parts of the day into things you suddenly have to think about. A dark staircase, a loose rug or getting up too quickly might feel very different when you are already unsteady.

Clear the clutter off the floor where you walk, and make sure your stairs, hallways and bathroom are well lit. If there’s a spot where you already feel a little shaky, a handrail or a non-slip mat can help a lot. And if you get dizzy while you’re standing up, don’t try to tough it out. Sit down somewhere safe and wait for it to pass.

Hearing also contributes information about what is happening around you, although it is not a substitute for the vestibular system. Hearing aids, when recommended for hearing loss, help you stay aware of voices, alarms and other environmental sounds.

If balance problems are continuing, tell the people close to you so they understand why you might need a little extra time or support.

Getting Answers About Your Balance and Hearing

A dizzy moment here and there doesn’t always mean something is wrong. If it keeps happening, balance testing can help figure out whether your inner ear is involved. The tests look at how your eyes, inner ear and body work together when you move.

At EarTech Audiology, we see patients in Ogden, Brigham City and Farr West, Utah. We’ll explain each test before we start and go over your results with you in plain terms. Call us at (866) 464-1008 to schedule an appointment at any of our locations.