Sometimes the semicircular canals swell and send incorrect balance signals. This problem may be caused by a viral infection. Depending on the cause, hearing can be affected (labrynthitis) or can remain normal (neuronitis). These episodes of vertigo last for hours or days. The first episode is usually the worst.


  • Drink plenty of water. Moisture is good for your voice. Hydration helps to keep thin secretions flowing to lubricate your vocal cords. Drink plenty (up to eight 8-ounce glasses is a good starting goal) of non-caffeinated, non-alcoholic beverages throughout the day.
  • Try not to scream or yell. These are abusive practices for your voice, and put great strain on the lining of your vocal cords.
  • Warm up your voice before heavy use. Most people know that singers warm up their voices before a performance, yet many don’t realize the need to warm up the speaking voice before heavy use, such as teaching a class, preaching, or giving a speech. Warm-ups can be simple, such as gently gliding from low to high tones on different vowel sounds, doing lip trills (like the motorboat sound that kids make), or tongue trills.
  • Don’t smoke. In addition to being a potent risk factor for laryngeal (throat) cancer, smoking also causes inflammation and polyps of the vocal cords that can make the voice very hoarse and weak.
  • Use good breath support. Breath flow is the power for voice. Take time to fill your lungs before starting to talk, and don’t wait until you are almost out of air before taking another breath to power your voice.
  • Use a microphone. When giving a speech or presentation, consider using a microphone to lessen the strain on your voice.
  • Listen to your voice. When your voice is complaining to you, listen to it. Know that you need to modify and decrease your voice use if you become hoarse in order to allow your vocal cords to recover. Pushing your voice when it’s already hoarse can lead to significant problems. If your voice is hoarse frequently, or for an extended period of time, you should be evaluated by an Otolaryngologist (Ear, Nose, and Throat physician.)


Diagnose and Understand Your Tinnitus

  • DO NOT panic. Tinnitus is usually not a sign of a serious, ongoing medical condition.
  • CHECK things out. The sounds you hear may actually be normal sounds created by the human body at work.
  • SEE an audiologist or ear, nose and throat specialist (ENT) interested and experienced in tinnitus treatment.
  • REVIEW your current medications (prescription, over-the-counter, vitamins and other supplements) with your medical professional to find possible causes of your tinnitus.
  • BE WARY of a hopeless diagnosis or physician advice like, “There’s nothing you can do about your tinnitus. Go home and live with it.”
  • BE a detective. Keep track of what triggers your tinnitus.
  • KEEP UP TO DATE about tinnitus. More and more research by the best and the brightest is bringing us closer to successful treatments and cures for tinnitus.

Find Effective Treatment and Take Care of Yourself

  • BE KIND to yourself. Developing tinnitus means you have undergone a significant physical, emotional and maybe even life-style change.
  • EXAMINE how you live to find ways to eliminate or reduce some stress in different parts of your life; stress often makes tinnitus worse.
  • PAY ATTENTION to what you eat. One-by-one, eliminate possible sources of tinnitus aggravation, e.g., salt, artificial sweeteners, sugar, alcohol, prescription or over-the-counter medications, tobacco and caffeine. (Do not stop taking medications without consulting with your health care professional.)
  • DON’T GIVE UP on a treatment if it doesn’t work right away. Some can take quite a while to have a positive effect.
  • PROTECT YOURSELF from further auditory damage by avoiding loud places and by using earplugs when you can’t avoid loud noise.

Your Attitude Matters

  • DO NOT create any negative forecasts for your tinnitus, such as “This is never going to get any better.” Counting on a better future can help you create one.
  • TAKE HEART. In many cases people with tinnitus “habituate” to it, meaning they get used to it and notice it less than at first.
  • BE INVOLVED in your recovery. Consider yourself part of your treatment team where your thoughts and feelings should count.
  • DO NOT WASTE time blaming yourself for your tinnitus. The causes of tinnitus are varied and difficult to determine.

Line Up Support

  • LOCATE people who understand your struggles and learn that you are not alone. Have people in your life who, though they cannot “see” or “hear” your tinnitus, understand that you have it.
  • FIND a support group that will truly understand your struggles with tinnitus and help you sort out useful from useless information. You will find compassion, companionship and coping strategies. (ATA has information on tinnitus support groups and individual, helpful volunteers.)
  • EDUCATE your family, friends and co-workers about tinnitus; tell them about the conditions and settings that are difficult for you; and ask them for their support.
  • CONTINUE SEEKING reliable information from ATA and other credible sources.


Do your best to prevent sinusitis by preventing underlying problems like getting colds and other infections and avoiding allergens. Try to also keep your sinuses as moist as possible.

  • Tips for Air Travel – use a nasal spray to keep your sinuses moist and drink plenty of fluids.
  • Prevent Colds – wash your hands frequently, stay away from infected people, eat balanced meals, exercise regularly and get plenty of sleep.
  • Avoid Allergens – wear a mask when you clean to minimize exposure to dust, sit in the non-smoking section of restaurants, avoid the outdoors during peak pollution hours, keep an air conditioner on during allergy season and clean the filter regularly
  • Maximize Moisture – use a humidifier, drink several glasses of water each day, avoid drying substances such as alcohol and coffee and avoid smoke.


  • For acute sinusitis some different treatment options include:
  • decongestant nasal spray use for a recommended time period, antibiotics for cases of sinusitis that are caused by viruses or intranasal corticosteroids.
  • For chronic or recurring sinusitis treatment options include nasal surgery:
    • Endoscopic Sinus Surgery – During this surgery blockages will be cleared allowing air to circulate and mucus to drain normally. Your surgeon may open up blockages by straightening the septum to allow for more breathing space; removing polyps; opening the ethmoid sinuses and clearing nasal passages.
    • Frontal Sinus Stenting – A new and highly successful procedure that has been proven very effective for recurrent or persistent sinus infections and complicated sinus illnesses. Research developed in our offices shows that stents left in place 6 months greatly improve the long-term outcome.
    • Allergy Testing & Treatment


  • Otology/Neurotology: diseases of the ear, including trauma (injury), cancer, and nerve pathway disorders, which affect hearing and balance.
  • Treating: ear infection; swimmer’s ear; hearing loss; ear, face, or neck pain; dizziness, ringing in the ears (tinnitus).
  • Pediatric Otolaryngology: diseases in children with special ENT problems including birth defects of the head and neck and developmental delays.
  • Treating: ear infection (otitis media), tonsil and adenoid infection, airway problems, Down’s syndrome, asthma and allergy/sinus disease.
  • Head and Neck: cancerous and noncancerous tumors in the head and neck, including the thyroid and parathyroid.
  • Treating: lump in the neck or thyroid, cancer of the voice box.
  • Facial Plastic and Reconstructive Surgery:cosmetic, functional, and reconstructive surgical treatment of abnormalities of the face and neck.
  • Treating: deviated septum, rhinoplasty (nose), face lift, cleft palate, drooping eyelids, hair loss.
  • Rhinology: disorders of the nose and sinuses.
  • Treating: sinus disorder, nose bleed, stuffy nose, loss of smell.
  • Laryngology: disorders of the throat, including voice and swallowing problems.
  • Treating: sore throat, hoarseness, swallowing disorder, gastroesophageal reflux disease (GERD).
  • Allergy: treatment by medication, immunotherapy (allergy shots) and/or avoidance of pollen, dust, mold, food, and other sensitivities that affect the ear, nose, and throat.
  • Treating: hay fever, seasonal and perennial rhinitis, chronic sinusitis, laryngitis, sore throat, otitis media, dizziness.


For acute sinusitis, symptoms include facial pain/pressure, nasal obstruction, nasal discharge, diminished sense of smell, and cough. Additionally, sufferers of this disorder could incur fever, bad breath, fatigue, and dental pain.Acute sinusitis can last four weeks or more. This condition may be present when the patient has two or more symptoms and/or the presence of thick, discolored nasal discharge throughout the day. Acute bacterial infection might be present when symptoms worsen after five days, persist after ten days, or the severity of symptoms is out of proportion to those normally associated with a viral infection.


Otolaryngology (pronounced oh/toe/lair/in/goll/oh/jee) is the oldest medical specialty in the United States. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. They are commonly referred to as ENT physicians.


Meniere’s disease is a vestibular disorder that produces a recurring set of symptoms as a result of abnormally large amounts of a fluid called endolymph collecting in the inner ear.

The prevalence of Meniere’s disease is difficult to assess. One population study found that 15.3 per 100,000 individuals develop Meniere’s disease annually. Of these, one-third eventually develop the disease in the second ear as well.

The exact cause of Meniere’s disease is not known. Theories include circulation problems, viral infection, allergies, an autoimmune reaction, migraine, and the possibility of a genetic connection. Experts also aren’t sure what generates the symptoms of an acute attack. Some people with Meniere’s disease find that certain triggers can set off attacks, including stress, overwork, fatigue, emotional distress, additional illnesses, pressure changes, certain foods, and too much salt in the diet.

Attacks can last from 20 minutes to 24 hours. They can occur many times per week; or they can be separated by weeks, months, and even years. The unpredictable nature of this disease makes it difficult to tell how it will affect a person’s future. Symptoms can disappear one day and never return, or they might become so severe that they are disabling.

Symptoms: During an attack of early-stage Meniere’s disease, the main symptoms are spontaneous, violent vertigo, fluctuating hearing loss, ear fullness, and/or tinnitus. Following the attack, a period of extreme fatigue or exhaustion often occurs, prompting the need for hours of sleep. The periods between attacks are symptom-free for some people and symptomatic for others.

Late-stage Meniere’s disease refers to a set of symptoms rather than a point in time. Hearing loss is more significant and is less likely to fluctuate. Tinnitus and/or aural fullness may be stronger and more constant. Attacks of vertigo may be replaced by more constant struggles with vision and balance, including difficulty walking in the dark and occasional sudden loss of balance. Sometimes, drop attacks of vestibular origin (Tumarkin’s otolithic crisis) occur in this stage of Meniere’s disease.

Treatment: In the United States, the most conservative long-term treatment for Meniere’s disease (aimed at reducing the severity and number of attacks) involves adhering to a reduced-sodium diet and using diuretics, or “water pills.” The goal of this treatment is to reduce inner ear fluid pressure. Some physicians, more commonly outside of the United States, also weigh the potential efficacy of using betahistine HCl (Serc) as a vestibular suppressant for Meniere’s disease.

Medications that are used during an attack to reduce the vertigo, nausea, and vomiting include diazepam (Valium), promethazine (Phenergan), dimenhydrinate (Dramamine Original Formula), and meclizine hydrochloride (Antivert, or Dramamine Less Drowsy Formula). Vestibular rehabilitation therapy is sometimes used to help with the imbalance that can plague people between attacks. Its goal is to help retrain the ability of the body and brain to process balance information.

Another recently introduced, conservative treatment approach employs a device to deliver a series of low-pressure air pulses designed to displace inner ear fluids. The use of this device is approved for general use by the U.S. Food and Drug Administration (FDA) and is currently undergoing clinical trials in the United States.

For the 20-40% of people who do not respond to medication or diet, a physician may recommend a chemical labyrinthectomy, which destroys vestibular tissue with injections into the ear of an aminoglycoside antibiotic (gentamicin). Another less conservative treatment is surgery to relieve the pressure on the inner ear (although this is not as widely used now as it was in the past) or to destroy either the inner ear or the vestibular nerve, so that balance information is not transmitted to the brain.


Sinusitis is an inflammation of the membrane lining of any sinus, especially one of the paranasal sinuses. Acute sinusitis is a short-term condition that responds well to antibiotics and decongestants. Chronic sinusitis is characterized by at least four recurrences of acute sinusitis. Either medication or surgery is a possible treatment.


To understand earaches you must first know about the Eustachian tube, a narrow channel connecting the inside of the ear to the back of the throat, just above the soft palate. The tube allows drainage – preventing fluid in the middle ear from building up and bursting the thin ear drum. In a healthy ear, the fluid drains down the tube, assisted by tiny hair cells, and is swallowed.

The tube maintains middle ear pressure equal to the air outside the ear, enabling free eardrum movement. Normally, the tube is collapsed most of the time in order to protect the middle ear from the many germs residing in the nose and mouth. Infection occurs when the Eustachian tube fails to do its job. When the tube becomes partially blocked, fluid accumulates in the middle ear, trapping bacteria already present, which then multiply. Additionally, as the air in the middle ear space escapes into the bloodstream, a partial vacuum is formed that absorbs more bacteria from the nose and mouth into the ear.