Dr Annabelle Leong

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Hear Well, Breathe Well, Sleep Well, Live Well.

Whether you are seeking care for yourself or your child, at ENTcare Clinic, we provide experienced assessment and treatment for a wide range of ear, nose and throat concerns.

Adult & Child ENT

Sleep Apnea and Snoring

Allergy (Sensitive Nose)

Ear and Hearing

Dizziness and Imbalance

Throat and Voice

Hear Well, Breathe Well, Sleep Well, Live Well.

Whether you are seeking care for yourself or your child, at ENTcare Clinic, we provide experienced assessment and treatment for a wide range of ear, nose and throat concerns.

Dizziness, Vertigo and Balance Treatment in Singapore

Dr Annabelle Leong 梁翠娟

Senior Consultant ENT SurgeonMBBS (Hons) (London), BSc (Hons); DOHNS, MRCS (England), FRCS ORL-HNS (England)

Understanding Dizziness, Vertigo and Imbalance

Dizziness, vertigo and balance problems can significantly affect your quality of life, but these terms can describe different sensations.

Dizziness or giddiness: A feeling of lightheadedness or unsteadiness.
Vertigo: A spinning sensation or the feeling that you or your surroundings are moving.
Imbalance: A feeling of instability or difficulty maintaining your balance.

Although these sensations can feel similar, the differences between them can reflect how the body’s balance system is being affected.

How Does the Body Maintain Balance?

Your sense of balance relies on information from several parts of the body working together:

Vestibular system: The inner ear helps determine the position and movement of your head and body.
Vision: The eyes provide visual information about your position and surroundings.
Proprioception: Sensory receptors in the spine, trunk and feet provide information about your body’s position and movement.

The brainstem coordinates these signals, sending feedback to the eyes to maintain steady vision and to the muscles to support posture and balance.

The vestibular system also helps resolve conflicting information between these sensory systems. When it is not functioning properly, dizziness, vertigo or imbalance may occur.

How Are Dizziness and Balance Problems Assessed?

Finding the cause of dizziness or imbalance starts with understanding exactly what you are experiencing. Dr Annabelle will take a detailed history of your symptoms, followed by an examination of the ears and neurological system.

A hearing test (audiogram) may also be performed, as some conditions that cause dizziness or balance problems can affect hearing as well.

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Dizziness and balance problems assessment

What Can Cause Dizziness, Vertigo and Imbalance?

Dizziness and balance problems can arise from several conditions affecting the inner ear and vestibular system. Treatment depends on the underlying cause.

CholesteatomaA cholesteatoma is a benign, expanding sac of skin that can damage surrounding ear structures, potentially causing hearing loss, dizziness and persistent ear infection. Treatment typically involves surgery to remove the cholesteatoma and prevent further damage.
Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) occurs when small calcium particles become free-floating within the inner ear. This can trigger short, recurrent episodes of vertigo when the head moves in certain directions, such as when turning over in bed.

BPPV can often be treated with a specialised Epley manoeuvre, which helps reposition the free-floating calcium particles that are causing the vertigo.
Ménière’s Disease
Ménière’s disease is an inner ear condition associated with abnormalities in the quantity and composition of inner-ear fluid. It can cause episodes of dizziness or vertigo alongside fluctuating hearing loss and tinnitus.

Medication may be prescribed to help control symptoms, with the type and dosage adjusted where necessary. If Ménière’s disease is accompanied by sudden hearing loss, steroid tablets or steroid injections into the ear may sometimes be considered to maximise recovery.
Acoustic Neuroma An acoustic neuroma is a benign tumour that grows on a nerve involved in hearing and balance. It may cause symptoms such as hearing loss, tinnitus or imbalance. Management depends on factors such as the tumour's size, growth and symptoms, and may include monitoring, surgery or radiotherapy.
Vestibular Migraine
Vestibular migraine can cause recurrent episodes of dizziness, vertigo or imbalance. Some people may also experience headaches or sensitivity to light and sound.

Treatment may involve medication to help control or prevent symptoms, depending on the frequency and severity of the episodes.
Labyrinthitis & Vestibular Neuronitis
Labyrinthitis and vestibular neuronitis affect the vestibular system and can cause sudden vertigo and ongoing imbalance. Labyrinthitis can also affect hearing, while vestibular neuronitis typically affects balance without causing hearing loss.

Where labyrinthitis occurs together with sudden hearing loss, steroid treatment may sometimes be considered to help maximise hearing recovery.

CPAP machine used to treat obstructive sleep apnoea

The full article covering dizziness, vertigo and imbalance may be found on page 33, The Business Times, 9 September 2018

Frequently Asked Questions About Dizziness and Vertigo

No. Dizziness can have different causes and does not always originate from the inner ear. The way your dizziness feels, when it occurs and any accompanying symptoms can help determine whether a vestibular problem may be involved.

Brief spinning sensations triggered by turning over in bed or changing the position of your head can occur with BPPV. This happens when displaced calcium particles within the inner ear move with changes in head position. An assessment can confirm whether BPPV is responsible, as other conditions can also cause dizziness.

The duration varies depending on the cause. BPPV commonly causes brief episodes triggered by certain head movements, while other vestibular conditions may produce different patterns of dizziness or vertigo. Persistent or recurring symptoms should be assessed to determine the underlying cause.

Consider an ENT assessment if dizziness or vertigo is persistent, keeps recurring or occurs with ear or hearing symptoms. Sudden hearing loss alongside dizziness should be assessed promptly, as timely treatment may help maximise hearing recovery.

Dr Annabelle Leong

Our Dizziness and Balance Specialist

Dr Annabelle Leong

Dr Annabelle Leong 梁翠娟

Senior Consultant ENT Surgeon

MBBS (Hons) (London), BSc (Hons);

DOHNS, MRCS (England), FRCS ORL-HNS (England)

Dr Annabelle Leong is a senior consultant ENT surgeon with more than 25 years of experience across the United Kingdom, Canada and Singapore. Dizziness and balance disorders are among her clinical interests, and she assesses patients experiencing vertigo, imbalance and related ear or hearing symptoms.

Depending on the underlying cause, treatment may include repositioning manoeuvres such as the Epley manoeuvre or medication.

More about Dr Annabelle