My name is Dr. Kelly Calkins and I am a doctor of audiology and I want to share with you my second personal story of “dizziness.” (And I sincerely hope not to have a third story any time soon!) Several years ago while ironically returning from a dizzy and balance seminar, I found that my ears would not “open” during my long flight home. I used a technique called “valsalva” where you close your mouth and pinch your nose closed and blow. Valsalva is used frequently with pilots and their crew and sometimes even used by scuba divers.
When blowing, it is critical not to blow too hard. My ears were so stopped up during this flight that I couldn't even hear my family who were sitting right next to me. Even though I knew better, I kept blowing harder and harder until finally I felt my ears pop. Unfortunately when my left ear popped, I knew I had probably ruptured something in my inner ear.
The next morning while sitting in a parking lot, my left ear felt “squirrely” (that's the only way I can describe the sensation). I put my thumb in my ear canal, made a tight seal and moved my thumb back and forth. As I moved my thumb my car also moved. If I moved my thumb slowly, the car rocked slowly. When I moved my thumb quickly, I had the sensation of violent motion.
The type of dizziness that I was experiencing is called a perilymph fistula (PLF). This is a condition where fluid from the inner ear leaks into the middle ear. Head injuries, some types of ear surgeries that correct middle ear bone movement called stapedectomies, straining, lifting heavy weights, forceful sneezing or coughing can cause PLFs. Some patients that have PLF will also report hearing loss, ringing in the ears (tinnitus), occlusion (a stopped up feeling), nausia and vomiting, and of course, dizziness.
After performing a tympanometry test in my office (which is primarily used to determine the health of the middle ear with pressure) I became dizzy when I increased the pressure. It was at this point I verified that I most likely had PLF. I was extremely careful for the next few months and avoided heavy lifting, straining, blowing my nose forcefully, and avoided all loud noises. My fistula repaired on its own, but it did leave me with a mild extreme high frequency hearing loss in my left ear. Some patients require surgery that a skilled otologist can perform to stop the leakage, however most repair on their own. If you are experiencing any vertigo or dizziness seek medical attention from your physician's audiologist.
Author Biography:
Kelly C. Calkins is a doctor of audiology and has practiced for over 20 years. She is the owner of Alpha Hearing and Balance, works with several otolaryngologists in Atlanta, GA, and is also affiliated with the American Institute of Balance. If you are experiencing dizziness or balance problems and you live in the Atlanta area, take a look at her clinic profile by clicking here or give her a call at 770-491-3900. To find another clinic in your area, simply type your zip code into the clinic locator near the top left hand corner of this page.