I’ve been told I have a Vestibular Hypofunction, what does that mean?
Essentially, the balance part of your inner ear is not working optimally. This can present on one side (unilateral) or both sides (bilateral) of the head.
Unilateral Hypofunction (on one side)
Imagine you are sitting in a row boat with an oar in each hand, both are equally responsible for navigating you through the water. Next, I want you to imagine that one of your oars has been damaged slightly. As you can imagine, it is now much harder to continue rowing in a straight line with the same efficiency as before. Similarly, damage to the vestibular system on one side of your head will result in balance impairment, dizziness and postural instability unless addressed with vestibular rehabilitation therapy. Treatment is aimed at encouraging central compensation, which essentially means that the normally functioning ear will now have a bigger workload to compensate for the damaged ear.
Bilateral Hypofunction (on both sides)
The difference with bilateral hypofunction is that we have damage to the vestibular system on both sides of the head. Typically, this may result in greater difficulty maintaining balance or in someone’s ability to see clearly during head movements. Given we can no longer rely on compensation from a ‘stronger’ side, treatment is aimed at optimising remaining inner ear function on both sides as well as the use of other systems such as the cervical-ocular reflex; a reflexive eye response elicited by rotation of the neck.
So, what’s the difference between Vestibular Neuritis and Labyrinthitis?
Firstly, let’s start with the similarities. Both neuritis and labyrinthitis are the result of an infection that causes an inflammatory response in the inner ear or the nerves connecting the inner ear to the brain. Consequently, there is a disruption to the transmission of sensory information (information about the world around you) from the ear to the brain which may result in symptoms of vertigo, dizziness and difficulties with balance, vision or hearing.
The difference between neuritis and labyrinthitis ultimately comes down to two factors; location of inflammation and hearing changes. Neuritis is a result of inflammation to the vestibular nerve with symptoms of vertigo, dizziness and imbalance but with no evidence of hearing changes. Conversely, Labyrinthitis is a result of inflammation to the labyrinth and shares many symptoms similar to neuritis, except that there is typically a loss in hearing on the affected side.
References
- University of California San Francisco. (c. 2021). Vestibular Hypofunction. San Francisco: Balance & Falls Center – Otolaryngology | Head and Neck Surgery. Retrieved from https://ohns.ucsf.edu/balance-falls/vestibular-hypofunction
- Kelders, WPA., Kleinrensink, GJ., van der Geest, JN., Feenstra, L., de Zeeuw, CI., Frens, MA. (2003). Compensatory increase of the cervico-ocular reflex with age in healthy humans. The Journal of Physiology, 553, 311-317. Retrieved from https://doi.org/10.1113/jphysiol.2003.049338
- VEDA. (c. 2021). Bilateral Vestibular Hypofunction. Retrieved from https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/bilateral-vestibular-hypofunction/
- VEDA. (c.2021). Labyrinthitis and Vestibular Neuritis. Retrieved from https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/