Hearing Health

Ear Balance Service

We offer a full and comprehensive balance assessment and rehabilitation service including:

  • Tests and treatments for benign paroxysmal positional vertigo (BPPV) – a common dizziness complaint due to debris gathering in a part of the balance organ where it doesn't belong causing brief bursts of severe spinning dizziness
  • Posturography – an assessment tool looking at an individual's overall function for balance
  • Balance function assessment via eye movement recordings and caloric testing – stimulating the balance organs in each ear to assess their function

  • Customised balance rehabilitation

read more about inner ear balance 


If you have a problem with your balance you should seek the advice of your GP. They may refer you to an Ear Nose and Throat (ENT) doctor who may then refer you to Audiology for a vestibular (balance) assessment.

What happens in the Balance Diagnostic Clinics?

The Audiologist will take a detailed history of your balance problems and you may be asked to complete some formal questionnaires. A number of tests will be performed including some gentle balance tasks which might require you to move your head and body posture to see if your balance is upset.

Detailed observation of your eye movements will also be undertaken using goggles placed over your eyes or via small electrodes placed near to both eyes which are connected to a computer. You will be asked to follow the movement of a light on a light-bar using your eyes. This enables the Audiologist to measure eye movements which are directly related to your balance.

The final test assesses the balance function of each ear independently by putting a small amount of air into each ear in turn.

How long does a Vestibular Assessment take?

A balance diagnostic appointment usually takes approximately two hours.

Rehabilitation & Therapy

Some people with balance problems benefit from a series of specially designed exercises combining head and body movements with eye exercises.

If you are considered a suitable candidate for this treatment, you will be given simple exercises to carry out at home and have your progress monitored by the Audiologist.

There are 3 main inputs that help you maintain good balance. They are related to vision, muscle tone and the balance organ in the inner ear. The rehabilitation exercises encourage these 3 inputs to become more coherent and work together.


Posturography is a measurement of body sway. It looks at the relationship between the balance organs in our ears, plus what our eyes and legs are telling us about where we are within our environment.

If you attend for a posturography appointment you will be asked to carry out two tasks.

The first task involves standing on a firm surface with the eyes open and then closed, followed by standing on a softer surface with the eyes open and then closed. This will give the audiologist a general indication about how efficiently your balance system is working.

The second task involves standing on a firm surface with your eyes open and, without moving your feet, swaying towards the points of a clock. This allows the audiologist to identify whether you have difficulty with your balance in one area more than another, i.e. is leftward movement better than right?

Both tasks may be performed as part of a vestibular rehabilitation program to allow the audiologist to identify whether there has been an improvement in your overall balance.

The time typically taken for this appointment is 45 minutes.

Epley Manoeuvre

The Epley repositioning manoeuvre or Canalith Repositioning Procedure (CRP) is a series of head movements designed to treat a specific balance problem called benign paroxysmal positional vertigo (BPPV), which has been diagnosed by an ENT Consultant.

BPPV is described as a balance problem related to free-moving tiny particles in a particular part of the balance mechanism. CRP is a method in which these particles are encouraged to move into an area of the balance system where they settle and do not affect the balance.

The Epley manoeuvre is conducted on a couch and consists of 5 head positions, which are quite rapid but controlled. The procedure will be carried out by an audiologist. The whole appointment will last approximately half an hour.

Typically, the manoeuvre is only done once but on occasions it may need to be repeated.

Useful Links

Dizziness and Balance.com

British Society of Audiology

NHS Conditions