Vertigo & Dizziness Treatment in Sydney

Vertigo is the sensation that you or your surroundings are spinning or moving when no actual movement is occurring. It is most commonly caused by inner ear disorders such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease. At Central Sydney ENT, our FRACS-qualified surgeons and vestibular physiotherapist provide comprehensive diagnosis and treatment for all types of vertigo and balance disorders across seven Sydney locations.

Symptoms of Vertigo

Vertigo can present with a range of symptoms that vary depending on the underlying cause. Common symptoms include:

• A spinning or rotating sensation, often triggered by changes in head position
• Nausea and vomiting during episodes
• Unsteadiness or difficulty walking in a straight line
• Nystagmus (involuntary, rapid eye movements)
• A feeling of fullness or pressure in the affected ear
• Hearing loss or tinnitus (ringing in the ears) in some cases
• Light-headedness or a sensation of floating

Common Causes of Vertigo

Most cases of vertigo originate in the inner ear, which contains the vestibular system responsible for balance. The main causes include:

Benign Paroxysmal Positional Vertigo (BPPV): The most common cause, BPPV occurs when tiny calcium carbonate crystals (otoconia) become dislodged from their normal position in the utricle and migrate into the semicircular canals. This causes brief but intense episodes of vertigo triggered by head movements such as rolling over in bed, looking up, or bending forward.

Vestibular Neuritis: An inflammation of the vestibular nerve, usually caused by a viral infection. This typically causes a single prolonged episode of severe vertigo lasting days to weeks, without hearing loss.

Meniere's Disease: A chronic inner ear condition characterised by episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of ear fullness. Episodes can last from 20 minutes to several hours.

Labyrinthitis: Similar to vestibular neuritis but also involving the cochlear nerve, causing both vertigo and hearing loss.

Superior Semicircular Canal Dehiscence: A rare condition where a thin or absent area of bone overlying the superior semicircular canal causes vertigo and sound-induced dizziness.

How Vertigo Is Diagnosed

Accurate diagnosis is essential because the treatment for each type of vertigo differs significantly. At Central Sydney ENT, our assessment typically includes:

Clinical history: A detailed discussion of your symptoms including onset, duration, triggers, and associated symptoms such as hearing changes or tinnitus.

Positional testing: The Dix-Hallpike test and roll test are used to identify BPPV by observing eye movements (nystagmus) during specific head position changes.

Audiometry: A comprehensive hearing test to identify any associated hearing loss, which helps differentiate between causes.

Vestibular function testing: Tests such as videonystagmography (VNG) or caloric testing may be used to evaluate how well the vestibular system is functioning.

Imaging: An MRI may be requested if there are concerns about central causes of vertigo, acoustic neuroma, or structural abnormalities.

Treatment Options

Treatment depends on the specific cause and severity of your vertigo:

Repositioning manoeuvres (Epley, Semont): For BPPV, these bedside manoeuvres move the displaced crystals back to their correct position. Most patients experience significant improvement after one to two treatments.

Vestibular rehabilitation therapy: A structured exercise-based program supervised by a vestibular physiotherapist to retrain the brain's ability to process balance signals. Central Sydney ENT works with Simba Health for vestibular rehabilitation.

Medication: Vestibular suppressants, anti-nausea medications, and betahistine (for Meniere's disease) may be used to manage symptoms during acute episodes.

Intratympanic therapy: For Meniere's disease that does not respond to conservative treatment, injections of gentamicin or corticosteroids through the eardrum may be recommended.

Surgery: Rarely required, but options include endolymphatic sac decompression for Meniere's disease or canal plugging for refractory BPPV or superior canal dehiscence.

When to See an ENT Specialist

You should seek assessment from an ENT specialist if you experience:

• Recurrent episodes of vertigo that do not resolve on their own
• Vertigo associated with hearing loss, tinnitus, or ear fullness
• Persistent imbalance or unsteadiness lasting more than a few days
• Dizziness that interferes with your ability to work or complete daily tasks
• Sudden onset of severe vertigo with new neurological symptoms (seek emergency care)

Our Specialists

Vertigo and balance disorders at Central Sydney ENT are assessed and managed by our team of six FRACS-qualified surgeons, with support from our on-site vestibular physiotherapist. Our otology specialists, including Dr Philip Yeung, have particular expertise in ear and balance conditions. All consultations are available at our Burwood main practice and satellite locations.

Related conditions: Perforated Eardrum • Eustachian Tube Dysfunction

Related procedures: Ear Surgery & Hearing • Audiology & Balance