How UChicago Medicine’s Dizziness and Hearing Clinic treats 3 common disorders
Roughly 1 in 5 adults experience dizziness and vertigo — conditions that can be disruptive or even debilitating — but there’s often a gap between patient demand and available healthcare providers who can help.
“It’s not rare that I’ll see someone who has had symptoms for many months, if not years,” said Marcello Cherchi, MD, PhD, a Clinical Associate of Neurology at the University of Chicago Medicine, where he also directs the Dizziness and Hearing Clinic.
The clinic, located at UChicago Medicine’s River East location, is led by a multidisciplinary team of neurologists, otolaryngologists and otologists (ENT doctors), audiologists, ophthalmologists and physical therapists.
“Many of the diseases we see straddle the boundary between brain disease and ear disease, because it’s at that interface that a lot of hearing and dizziness problems can occur,” Cherchi said.
The clinic model, unique to UChicago Medicine, is designed to help get answers quickly. Before their arrival, patients complete a questionnaire to help determine which tests to conduct. Those tests — and a consultation with Cherchi — take place during the same visit.
“By the end of the day, I’ve got all the information I need to secure a diagnosis and come up with a treatment plan,” Cherchi said.
Most disorders seen at the clinic are not preventable, but many can be managed with physical therapy and, less frequently, with medication. Surgical interventions are rare, Cherchi said.
Cherchi spoke about three common issues the clinic diagnoses and how they can be treated:
1. Benign paroxysmal positional vertigo (BPPV)
What it is: Also known as “ear rocks” or “ear crystals,” BPPV is the most common disorder seen by clinic staff. The inner ear has tiny calcium crystals that make one sensitive to gravity — and they can get loose, causing dizziness. People with BPPV may experience spinning or dizziness that can last for minutes at a time. “It’s astonishingly common,” Cherchi said.
How it’s treated: Clinic specialists assess the patient’s eye movements when they’re placed in particular positions, and they typically prescribe several physical therapy visits — usually without the need for medications or surgery. “This is a group of patients who generally have a good prognosis,” Cherchi said.
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2. Vestibular neuritis
What it is: Often a one-time disease, this inner ear disorder is thought to be caused by damage to the vestibular (or balanced-related) nerve between the ear and brain. It can cause severe spinning, dizziness, nausea and vomiting that can last hours or even days. “When it first occurs, it’s quite terrifying.” Cherchi said. “People don’t know what it is, and they fear the worst.”
How it’s treated: A tricky aspect of diagnosing vestibular neuritis is distinguishing it from life-threatening conditions, such as strokes. Treatment involves intensive physical therapy to help people move their eyes, head and body. “Their recovery is slower than everybody wants, but they generally do well once they start appropriately targeted physical therapy,” Cherchi said.
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3. Ménière’s disease
What it is: Less common than the others, Ménière’s disease causes people to develop issues in just one ear. The patient’s hearing drops out, or they hear sounds such as crashing waves or jet planes. Symptoms such as dizziness, nausea, spinning and vomiting can be severe. Episodes can last hours or up to a day or more.
How it’s treated: The management of Ménière’s disease is more multifaceted than that of other diseases. Treatment typically starts with one of several available oral medications. If those don’t work, the clinic may suggest procedural interventions.
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Expert care for hearing and dizziness issues
For these and many other conditions, the clinic’s multidisciplinary approach allows the UChicago Medicine care team to determine diagnoses and treatments that otherwise might slip through the cracks with more siloed care.
“We don’t just come at it from either a neurology or ENT perspective — we intentionally straddle both,” Cherchi said.
Learn more about dizziness and hearing care at UChicago Medicine