Understanding Dizziness, Vertigo & Balance Disorders
Florida Gulf Coast Ear, Nose & Throat
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Aug 08, 2023
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What Is a Balance Disorder? Your sense of balance is critically important to help prevent falls and injury. A balance disorder affects your body’s ability to hold an upright, safe position and is often experienced as dizziness and vertigo. Dizziness is a feeling of being unsteady or having a distorted sense of your body in the space in the space around it. Vertigo involves a sense a movement, as if you or the environment around you is spinning. Dizziness and vertigo can be accompanied by lightheadedness, blurred vision, confusion, disorientation, nausea, and vomiting. Dizziness and vertigo are symptoms of numerous conditions, including anxiety, dehydration, circulation issues, nervous system and brain conditions, medication side effects, and inner ear disorders. An ENT can help you determine if your dizziness or vertigo is caused by an inner ear disorder.
Balance and the Inner Ear Your sense of balance is guided by signals from your eyes, ears, and sensory receptors to your brain. The part of your ears involved in balance is called the vestibular system, a structure of bone and soft tissue located in your inner ear. Within this structure are loop shaped canals that contain fluid hairlike sensors. When you move your head, the fluid in the vestibular system causes the hairlike sensors to bend, sending a signal to your brain that your head has changed position. With this information, your brain can send signals to other parts of the body, such as your eyes and muscles, to move your body’s position and visual focus to help maintain your sense of balance. When any part of the vestibular system is injured or malfunctioning, proper signals to your brain can be disrupted, causing you to feel imbalanced. When the vestibular system is the cause of your sense of imbalance, it is called a vestibular disorder.
Common Vestibular Disorders
Autoimmune Inner Ear Disease (AIED) Autoimmune Inner Ear Disease is caused by a malfunctioning immune system that attacks healthy ear tissue. It affects both ears and causes hearing loss and balance issues. Once symptoms are present, they typically progress quickly. AIED is rare, affecting 15 out of 100,000 people, and is most common in middle-aged women. It commonly occurs with other autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma, and ulcerative colitis. Acoustic Neuroma Acoustic neuroma is a benign (non-cancerous) tumor that grows on the nerves in the inner ear that are responsible for hearing and balance. The pressure on the nerve from the tumor may cause hearing loss and imbalance. Benign Paroxysmal Positional Vertigo (BPPV) Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. The structures in your ear that monitor your head's movements crystals that make you sensitive to gravity. These crystals can become dislodged for several reasons, such as serious trauma to the head or even minor trauma such as a violent sneeze or bumping your head into something. When the crystals become dislodged, they can move into the canals of the vestibular system and create a fall signal of head movement, causing dizziness. Benign paroxysmal positional vertigo can occur at any age but is most common in people over the age of 50.Mal de Debarquement Syndrome (MdDS)
Mal de Debarquement Syndrome (MdDS) Mal de Debarquement Syndrome is a rare condition that causes a severe and often debilitating feeling of swaying or bobbing, much like motion sickness but without motion. It often follows boat or ship travel but can persist for months or longer. While it is a neurological condition rather than a vestibular condition as it does not involve the inner ear, patients often see ENT physicians for a diagnosis. Ménière’s Disease Ménière’s disease causes severe vertigo, ringing in the ears, hearing loss, and a feeling of fullness or congestion in the ear. In Ménière’s disease, a buildup of fluid in the inner ear interferes with the vestibular nerve’s ability to send signals that regulate balance to the brain. Ménière’s disease usually affects only one ear but over time can progress to affect both ears. Labyrinthitis Labyrinthitis is a disorder of the inner ear that occurs when one of the vestibular nerves becomes inflamed. It is commonly caused by a viral infection, such as an upper respiratory infection or the flu, or less commonly by a bacterial infection such as strep throat or pneumonia. Otosclerosis Otosclerosis is a rare condition characterized by an abnormal growth of bone of the middle ear. It commonly affects hearing loss, and less commonly can affect balance if the growth extends into the inner ear. Ototoxicity Ototoxicity is caused by exposure to certain drugs or chemicals that damage nerves in the inner ear that are responsible for hearing and balance. There are more than 200 prescription and over-the-counter medications and chemicals that are known to cause ototoxicity. Discuss with your doctor the potential for hearing or balance damage of any medication you are taking. Vestibular Migraine Vestibular migraine is one of the most common causes of spontaneous vertigo, loss of balance and sensitivity to motion. Unlike other migraines, vestibular migraine may or may not feature headache, although most people diagnosed with vestibular migraine have a history of migraine headaches. Although vestibular migraine is a neurological condition, it can mimic vestibular conditions such as Ménière’s disease and patients should consult an ENT physician to rule out any inner ear disorders. Vestibular Neuritis Vestibular neuritis, or vestibular neuronitis, is characterized by inflammation of the vestibular nerve in the inner ear. It causes a sudden case of severe vertigo, dizziness, balance problems, nausea and vomiting that can last for minutes or prolonged over several days. Vestibular neuritis is typically caused by a virus either in the ear or elsewhere in the body.
Diagnosing Vestibular Disorders
The otolaryngologists at Florida Gulf Coast ENT and the audiologists at Florida Gulf Coast Hearing Center are trained to performed diagnostic tests for vestibular function. Tests they may perform include: Your otolaryngologist may consult with other physicians such as neurologists to assess neurological conditions, and cardiologists to assess circulatory conditions. Hearing tests – To evaluate hearing functionality Electrocochleography (ECoG) – Measures inner ear fluid pressure Electronystagmography (ENG) or Videonystagmography (VNG) — Measures eye movement and the muscles that control them Head movement testing – Evaluates the effect of tilting your head Rotational chair testing – Measures eye movements while you sit in a computerized chair that moves Posturography – Measures your ability to maintain proper posture under different test conditions Subjective visual vertical test (SVV) – Measures how your inner ear senses gravity Vestibular evoked myogenic potential (VEMP) – Evaluates the functionality of the inner ear and vestibular nerve Blood tests - To check for infections Your otolaryngologist may consult with other physicians such as neurologists to assess neurological conditions, and cardiologists to assess circulatory conditions.
Treating Vestibular Disorders Your treatment plan will depend on which type of vestibular disorder you have. Options may include: Medications to treat an infection Medications to prevent vertigo and nausea Treatment of underlying conditions Surgery to repair inner ear function Dietary changes Activity changes Physical or occupational therapy Be Safe When Feeling Dizzy Dizziness and vertigo increase the risk of falling and injuries. To minimize this potential, consider taking these safety precautions: Minimize driving Minimize going up and down the stairs Walk with a cane or walker Install “grab bars” in the bathroom Wear low-heeled shoes .
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- Seniors Blue Book was not involved in the creation of this content.
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Physicians 2180 Immokalee Road, Naples, Florida, 34110Florida Gulf Coast ENT offers comprehensive ear, nose, and throat (ENT) care for adults and children. Led by a team of board-certified and fellowship-trained specialists, including Samuel L. Hill, III, MD, FACS, FAAOA, Patrick M. Reidy, MD, Leela Lavasani, MD, FACS, Sue-Lay Plasencia, DNP, ARNP, NP-C, Benjamin Lehmkuhl, DO, Nicole Gergenti, FNP-BC, and Christie McGee, MD, we provide diagnostic, therapeutic, and surgical services. Whether you're experiencing a persistently runny nose, trouble breathing, or issues with your hearing, our team is here to help. Schedule an appointment at one of our convenient locations in Naples, Estero, Pine Ridge, or Downtown Naples. Get lasting relief and improve your quality of life with Florida Gulf Coast ENT.Our physicians, Samuel L. Hill, III, MD, FACS, FAAOA, Patrick M. Reidy, MD, Leela Lavasani, MD, FACS, Price Sonkarley, MD, FACS and Sue-Lay Plasencia, DNP, ARNP, NP-C, are Board Certified, fellowship trained specialists who are supported by a team of highly skilled medical professionals.Our DoctorsAs co-founders and managing partners of Florida Gulf Coast Ear, Nose and Throat, LLC, Dr. Hill and Dr. Reidy are committed to excellence! Their goal is to provide patients with high quality service utilizing the most advanced therapeutic and surgical treatments. Drs. Reidy and Hill achieve this goal by developing a close personal relationship with their patients, and through continued training in the most up-to-date technologies available in their field.Samuel L. Hill, III, MD, FACS, FAAOABOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONUniversity of Michigan Bachelor of Science Magna Cum LaudePOSTGRADUATE TRAININGWayne State University Detroit Medical Center Doctor of MedicineWayne State University Detroit Medical Center Internship General SurgeryWayne State University Detroit Medical Center Residency Otololaryngology/Head & Neck SurgeryEar Research Foundation at The Silverstein Institute Fellowship Neuro-otology/Advanced Otologic and Skull Base SurgeryPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican College of SurgeonsAmerican Academy of Otolayngic AllergyFlorida Medical AssociationCollier County Medical SocietyLee County Medical SocietyWayne State University Medical Alumni SocietyUniversity of Michigan Alumni SocietyPatrick M. Reidy, MDBOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONUniversity of Michigan Bachelor of Science GO BLUE!!POSTGRADUATE TRAININGWayne State University Detroit Medical Center Doctor of MedicineWayne State University Detroit Medical Center Internship General SurgeryWayne State University Detroit Medical Center Residency Otololaryngology/Head and Neck SurgeryUniversity of Chicago Medical Center Fellowship Rhinology / Allergy / Advanced Sinus SurgeryPROFESSIONAL MEMBERSHIPSAlpha Omega Alpha Medical Honor SocietyAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican Rhinological SocietyFlorida Medical AssociationCollier County Medical SocietyLee County Medical SocietyUniversity of Michigan Alumni SocietyWayne State University Medical Alumni SocietyLeela Lavasani, MD, FACSDr. Lavasani offers a comprehensive program of specialized ear, nose and throat care that reflects our commitment to delivering individualized and optimal treatment to patients of all ages. She has the experience and skill to provide comprehensive diagnosis and management of diseases that affect the ears, nose and paranasal sinuses, voice, throat, thyroid and neck.BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONMacalester College Bachelor of Arts BiologyPOSTGRADUATE TRAININGChicago Medical School- Masters of Science- Applied PhysiologyGeorge Washington University School of Medicine Doctor of MedicineThomas Jefferson University Residency OtolaryngologyPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican College of SurgeonsAmerican Medical Womens AssociationAlpha Omega Alpha of OtolaryngologyCollier County Medical SocietyBenjamin Lehmkuhl, DOFlorida Gulf Coast ENT is happy to welcome our newest physician to the team, Dr. Ben Lehmkuhl. A native from Iowa, Dr. Lehmkuhl graduated medical school from Des Moines University, and then completed his otolaryngology, head and neck surgery residency at the University of Kentucky. During his training, Dr. Lehmkuhl became fond of taking care of the entire familys ear, nose, and throat complaints and dedicated himself to learning to provide care for patients of all age ranges from newborns to geriatrics. He enjoys taking care of patients with hearing loss, balance disorders, ear infections, sore throats, sinus disease, nasal obstruction, allergies, neck masses, thyroid nodules, voice complaints, sleep disturbances and swallowing difficulties, as well as pediatrics. BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck Surgery EligibleState of FloridaEDUCATIONClarke University, Debuque, IA Bachelor of Science in BiologyPOST GRADUATE TRAININGDes Moines University, College of Osteopathic Medicine, Des Moines, IA -Doctor of Osteopathic MedicineWestern Reserve Hospital, Cuyahoga Falls, OH Otolaryngology Head and Neck Surgery ResidencyUniversity of Kentucky, Lexington, KY Otolaryngology Head and Neck Surgery ResidencyPROFESSIONAL MEMBERSHIPS:American Academy of Otolaryngology Head and Neck SurgeryKentucky Society of OtolaryngologyAmerican Osteopathic Association MemberLee County Medical Society MemberChristie McGee, MDA native of South Florida, Dr. McGee completed Otolaryngology residency training in Miami, FL, and is excited to utilize her comprehensive skills and training to treat the community of Collier County. Dr. McGee offers comprehensive surgical and medical Otolaryngologic care to patients of all ages for the following conditions:Diseases of the Paranasal Sinuses and Nasal Cavity including allergic rhinitis, chronic rhinosinusitis, sinonasal polyp disease, complex sinus infections, deviated septum, nasal obstruction, nosebleeds, and smell lossAcute and chronic hearing loss, ear infections, perforated eardrum, eustachian tube dysfunction, vertigoPediatric sleep-disordered breathing, tonsillectomy, adenoidectomy, ear tubes, congenital lesions, speech and swallow disordersDiseases of the airway and larynx including voice and swallow changes, vocal cord paralysis, benign lesions, and malignancies, as well as tracheostomy and cervical airway scar tissue managementBenign and malignant lesions of the upper aerodigestive tract, thyroid gland, neck, salivary glands, and skin of the head and neckFacial paralysisAge-related changes of the face including management of wrinkles with BotoxAdult surgical management of obstructive sleep apnea and snoringBOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology- Head and Neck Surgery EligibleState of FloridaEDUCATIONUniversity of Florida- Bachelor of Science in Biology- Magna Cum LaudePOSTGRADUATE TRAININGTufts University School of Medicine- Masters of Science in Biomedical SciencesUniversity of Miami Miller School of Medicine- Doctor of MedicineUniversity of Miami/Jackson Memorial Hospital- Residency- Otolaryngology and Head and Neck SurgeryPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology- Head and Neck SurgeryAmerican Rhinologic SocietyFlorida Society of Otolaryngology- Head and Neck SurgeryGold Humanism Honor SocietyCollier County Medical SocietyNicole Gergenti, FNP-BCNicole Gergenti is a board certified Family Nurse Practitioner. She was born in New York but raised in Southwest Florida. She has always had a passion for serving others, which is what drove her ambition to pursue a career in the medical field. After obtaining her first bachelors degree in human performance from Florida Gulf Coast University, she quickly knew the career path she wanted to pursue. She then acquired her second bachelors degree in nursing from Nova Southeastern University. She began her nursing career as a registered nurse for Lee Health on their surgical oncology unit. During her time working at the hospital, she continued her education at Nova Southeastern University and obtained her masters in nursing as a Family Nurse Practitioner. She strives to always listen to and provide her patients with the utmost best care possible.EDUCATIONFlorida Gulf Coast University- Bachelor of Science in Human PerformanceNova Southeastern University- Bachelor of Science in NursingNova Southeastern University- Masters in NursingSuelay Plasencia, DNP, APRN, NP-CSuelay Plasencia is a board-certified doctorate prepared Family Nurse Practitioner. She is born and raised in Florida and has extensive nursing experience in critical care and oncology. She started her career as a nurse at Moffitt Cancer Center and continued her oncology career at Lee Memorial Hospital. She has transitioned her education into a nurse practitioner with training at Moffitt Cancer Center and several outpatient family practices. Sue is passionate about providing affordable and convenient care for all patients. She has the dedication and skill to provide detailed care for diseases affecting the ear, nose, paranasal sinuses, throat, thyroid, and neck.BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Academy of Nurse Practitioners- Family Nurse PractitionerState of FloridaEDUCATIONSouth University Tampa- Bachelor of Science in NursingPalm Beach Atlantic University- Doctorate in Nursing PracticePROFESSIONAL MEMBERSHIPSSigma Theta Tau Honor SocietyAmerican Academy of Nurse PractitionersOncology Nursing SocietyNurse Practitioner Council of Collier CountyNurse Practitioner Council of Lee CountyChristopher Hatwell, PA-C, MMSBorn and raised in New Jersey, Christopher has called Southwest Florida home for 25 years. He completed his physician assistant training at Nova Southeastern while serving as class president and graduating with honors. He has practiced locally since graduation with experience in family practice as well as neurology. He has a passion for treating illness, patient education and expanding his medical knowledge to help better treat his patients. When not in the office he can be found with his wife and two sons playing sports and enjoying the beaches and waterways of Naples.Audiology TeamSHANAI HILL, AU.D., CCC-ADr. Shanai Hill has been with Florida Gulf Coast ENT and Hearing Center since its inception in 2005. She helped to create the Audiology Department alongside her husband, Dr. Samuel Hill and his partner, Dr. Patrick Reidy. She currently provides hearing and hearing aid services including hearing aid evaluation, demonstrations, repairs, and sales at our Estero location. Dr. Hill believes that the hearing rehabilitation process should be much more than a retail transaction. She is dedicated to working closely with her patients as they embark on their journey to better hearing. She provides continuous education, counseling, validation and technological support for her patients and their families in order to improve their communication abilities and their overall quality of life.Prior to her time with FCGHC, she practiced Pediatric Audiology at All Childrens Specialty Care Center/Johns Hopkins in Ft. Myers and the Childrens Hospital of Michigan. During that time, she diagnosed and treated pediatric hearing loss including participating in the Craniofacial/Cleft Palate Team and the Cochlear Implant Team. She also spent 2 years in the Michigan Public Schools System as an Educational Audiologist providing hearing therapy and hearing aid/ FM unit support for hearing impaired students.Dr. Hill has a Bachelor of Arts degree in Communication Disorders from Michigan State University, a Master of Science degree in Audiology from Wayne State University, and a Doctor of Audiology degree from the University of Florida. In her spare time, she enjoys traveling, cooking, having fun with her husband and teenage boys, and serving at her church.NICOLE DIEHL, AU.D., CCC-A, FAAADr. Diehl began her higher education by receiving a Bachelor of Science in Communication Sciences and Disorders from Ohio University in 2011. She later when on to obtain a Doctorate of Audiology at East Tennessee State University. During this time, she was trained at the Mountain Home Veterans Affairs Medical Center in evaluations of hearing, balance, tinnitus, and fitting of hearing aids and other assistive devices.Following her graduation from East Tennessee State University, she worked in private practice as well as at an ear, nose, and throat specialist. She worked in Dalton, Massachusetts as a diagnostic and dispensing audiologist at a private practice ENT for both adult and pediatric populations before relocating to Florida. Dr. Diehl is committed to improving her patients quality of life using state-of-the-art hearing technology.ELVERA BADER AU.DDr. Elvera Bader joined Florida Gulf Coast ENT in 2023 after moving to Florida with her husband and two daughters. Originally from New York, Dr. Bader earned her bachelors degree in communication sciences and disorders from CUNY Brooklyn College and her doctorate in Audiology from the CUNY Graduate Center in NYC.Before joining Florida Gulf Coast ENT, Dr. Bader worked independently at a small boutique practice in NYC, specializing in the hearing healthcare needs of musicians and others in the music industry. She later joined a busy Otolaryngology practice affiliated with the Northwell Health System, where she spent five years. During this time, she was part of a comprehensive team of providers focusing on the diagnosis and treatment/management of hearing disorders from birth through adulthood.Dr. Bader is dedicated to providing evidence-based care in a personalized, patient-centered approach, guiding her patients on their journey to improved hearing.