Hearing & Balance Doctors


Your Balance Is a Critical Element to Your Overall Health

You only realize how much you have taken your balance for granted when you start to experience challenges.

Being off-balance can be scary, impacting your confidence and preventing you from leaving your house. Nobody should have to deal with the pain of watching their spouse, parent, or grandparent go through such difficult circumstances.

When maintaining your balance becomes a significant challenge, you run the risk of severe injury if you should fall. However, other issues, such as vertigo, can also impact receiving proper nutrition, relaxing in your favorite chair, or being able to fall asleep. Finding solutions to these issues is a critical part of your and your family’s overall health.

Because your inner ear plays a crucial role in helping you to maintain your balance, our team of audiologists specializes in identifying and finding solutions for those who experience vertigo and difficulties maintaining their balance.

By identifying the causes and solutions to correct balance issues, our specialists have helped thousands of families, just like yours, to return to their normal daily routine without fear.

Schedule Your Balance Consultation

Dr. Richard Luekenga, Au.D., CCC-A, F-AAA, Owner and Audiologist at Hearing and Balance Doctors

How Are Your Ears Involved in Balance?

Your inner ear not only helps you to hear but also helps you to maintain your balance. Within your inner ear is a structure shaped like a snail shell called the cochlea. Within this structure are a series of loops and canals referred to as the vestibular system.

When normal, the vestibular system functions similar to the bubble used in a carpenter’s level.

Three sets of semicircular canals and two sacs work together to detect linear motion, and when your body is out of balance, it sends a nerve signal to your brain, which then sends out instructions to other parts of your body to help you make the necessary adjustments.

If any of the elements (sacs, semicircular canals, nerves, etc.) are not working properly, then this can result in dizziness or vertigo.

What Causes Inner Ear Balance Problems?

Hearing Loss Is Connected to Balance Disorders

Hearing problems, according to a variety of studies, can affect balance and increase your risk of falling. “The sounds we hear affect our balance by giving us important information about the environment. We use sound information to keep ourselves balanced, especially in cases where other senses, such as vision or proprioception, are compromised,” reports Maura Cosetti, M.D., an associate professor of otolaryngology at the Icahn School of Medicine at Mount Sinai.

Due to this connection, individuals who are experiencing balance disorders undergo screening for hearing loss as a part of assessing their condition. Because balance is heavily dependent upon the proper functioning of inner ear components, additional causes that affect these components can contribute to both issues as well, including:

Labyrinthitis or Vestibular Neuronitis

Labyrinthitis or Vestibular Neuronitis is a result of inflammation in the labyrinth structure of the inner ear. It stems from some sort of infection, producing tinnitus and hearing loss. Labyrinthitis and vestibular neuronitis are nearly identical, except the latter does not include hearing loss.

Meniere’s disease

Meniere’s disease results from increased pressure within the labyrinth structure. Meniere’s disease typically affects only one ear but can affect both. The condition often disappears within a few years, but medications can help manage the condition.

Perilymph Fistula

Perilymph Fistula occurs whenever fluid from the inner ear leaks into the middle ear. Leakage is usually the result of a severe ear infection that’s related to head injury, a complication of head surgery, or a birth defect, but it can also appear after scuba diving.

Proper testing by an audiologist helps to identify these causes as well as provide the framework for hearing care that will aid in correcting balance issues.

Balance Testing By Our Doctors of Audiology

The doctors of audiology at our clinic specialize in diagnosing inner ear-related balance issues. Balance testing is similar to a hearing assessment, which begins with a thorough case history that includes a description of the symptoms, their onset, severity, and duration. Your general medical history, including a list of the medications you take as well as your occupation and common activities, contribute critical information to identifying the cause of balance issues.

After the initial discussion of your condition and history, your audiologist will conduct a variety of tests to fully identify the underlying cause of your balance disorder. These tests include:

A Hearing Test

A hearing test, which is designed to rule out certain contributing inner ear issues affecting both hearing and dizziness.


Tympanometry, which helps your doctor to rule out the possibility of fluid behind the eardrum (often associated with allergies or infections) as a potential cause.

Computerized Dynamic Posturography

Computerized dynamic posturography, which helps to determine whether your dizziness relates to inner ear issues instead of somatosensory or vision issues. This test includes securing the patient with a safety harness while standing on a moving platform and surrounded by moving walls.

Auditory Brain Stem Response

Auditory brain stem response, which measures hearing sensitivity and evaluates the efficiency of the neural pathways in the process of transmitting sound within the brainstem, which can rule out tumors (such as a vestibular schwannoma) as the source of dizziness.


Vestibular evoked myogenic potential (VEMP test), which allows your audiologist to evaluate the function of the saccule and the inferior branch of the vestibular nerve as possible causes of a balance disorder.

Oculomotor Tests

Oculomotor tests, which focus on the connection between your eyes and inner ears via the vestibulo-ocular reflex as a possible cause of dizziness or vertigo. Specialized goggles with infrared cameras allow your doctor to observe eye motions associated with various inner ear issues.

Positional Tests

Positional tests (including the Dix Hallpike maneuver), which help to rule out the presence of loose otoliths or “crystals” in the semicircular canals.

Air Caloric Testing

Air caloric testing, which is designed to detect labyrinthitis and vestibular neuronitis by blowing either cool or warm air into the ear canal. As the temperature of the air transfers through the eardrum to the inner ear, the fluids within the inner ear begin to move. This causes the patient to feel a sense of motion, which is observable through the eyes, allowing your audiologist to evaluate the status of inner ear components.

When performed together, this battery of tests comprises a typical “balance test.” They are designed to rule out certain causes and zero in on the specific source of a balance issue.

Audiologist performing balance test

Our Doctors Have Solutions for Your Balance Issues

In addition to increasing your risk of serious injury from a fall, balance issues affect your overall health and make you afraid to leave your home, decreasing your independence and reducing your quality of life. Our audiologists can thoroughly evaluate your inner ears and provide appropriate solutions to help you achieve better balance and get back to your regular routine.

It’s difficult to watch a loved one experience balance issues, especially when it begins to affect their quality of life.

So whether you, your spouse, grandparent, or parent is experiencing dizziness or vertigo, feels out of balance, or has developed a hearing loss, schedule an appointment today.