Nasal Obstruction – All You Need to Know

Breathing is something we often take for granted. It’s easy not to focus on it until there is an issue and we struggle. If you have trouble breathing normally through your nostrils, it could be due to nasal obstruction. Here we look at what causes nasal obstruction and the symptoms to look out for.

Nasal Obstruction

Nasal obstruction is a condition in which a nostril, or sometimes both nostrils, become blocked. This is almost always a temporary condition that can usually be easily treated in most cases. That said, some causes of nasal obstruction can require surgery.

Several things can cause nasal obstruction. These include:

  • Colds / viral illnesses
  • Sinusitis
  • Medication overuse, such as nasal decongestants such as Sudafed or Otrivine
  • Allergies
  • In children or vulnerable people, it could be due to an object that has been inserted into the nostril.

Different types of Nasal Obstruction

Sometimes nasal obstruction can be due to a congenital cause, such as choanal atresia, which is present at birth. In this case, a thin membrane blocks the back of the nose, preventing the passage of air from the outside through the nostril to the throat. This can be a problem in very small babies who tend to rely on their nasal breathing in the first few weeks of life.

One of most common causes in adults is due to a deviated septum, which can also hinder nasal breathing. The septum is the part of the nose that separates the nose into two halves, and when it is misaligned, it will likely affect breathing. The septum can be deviated from birth, or can be due to trauma.

Other possible causes of nasal obstruction include nasal polyps, oversized adenoids and swelling due to allergies.

Nasal Obstruction – Treatment

Treatment for nasal obstruction will depend on the initial cause. An ENT specialist, such as London ENT, will use a nasal endoscope, CT scan, or MRI to determine a diagnosis before forming a treatment plan.

Steroid-based sprays or drops are often used to treat nasal obstruction related to allergies or sinus issues. Surgery is likely needed if the cause is nasal polyps or a deviated septum. Septoplasty surgery is performed under general anaesthetic and takes around 30-45 minutes. Patients usually notice a significant improvement in their nasal breathing after this.

When to Seek Help

If you are suffering from the symptoms of nasal obstruction and there is no apparent cause, you should seek advice. Nasal congestion may lead to bigger issues, such as nosebleeds, snoring, facial pain, and poor sleep, all of which can affect your physical and even mental health. Booking an appointment to discuss your symptoms is the best way to ensure you receive the most effective treatment to enable easy breathing through your nostrils.

Contact London ENT on 0203 8657225 to learn more about the specialist ENT treatments and consultations we offer.


Looking After Your Sinuses in Spring

Spring is a wonderful time of year, with brighter days, vibrant flowers and new beginnings all around – not to mention the extra chocolate! However our nose and sinuses do not always agree with this seasonal change. Read on to find out the most effective way to look after your sinuses during spring.

Let Yourself Rest

Did you know that our bodies are more vulnerable to infection and illness when we are run down? Sinus infections are more likely to strike if you have not rested well. This is why taking the time to rest is important when it comes to looking after your sinuses and your overall health. Getting enough sleep will give your body the energy it requires to fight off illness. If you feel run down, avoid hard-hitting activities such as cardio exercise and manual work. This will slow down healing and aggravate current issues.

Look at Your Diet

Have you considered a hypoallergenic diet? This is a diet low in histamines, which are chemicals released as a response to allergens. Histamines can enhance sinus issues, and some foods are high in histamines. These foods include processed foods, cured meat, shellfish, citrus fruits, aged cheeses and tomatoes. Eliminating or at least reducing these foods from your diet will determine if your symptoms are sensitive to histamines as you should hopefully see some improvement in your symptoms within two weeks. Keeping a food diary is a good way to track this. If you identify food that triggers symptoms, eliminate it completely and strictly for two to four weeks and monitor your symptoms.

Salicylates are naturally occurring chemicals which can reduce inflammation and relieve pain. However some people have an allergy to salicylates and therefore salicylate containing foods could present a problem. Salicylates are also the active ingredient in the painkiller aspirin, so it is common for patients with salicylate allergy to be intolerant to aspirin or other similar non-steroidal type analgesics (NSAIDs). Having asthma or nasal polyps also increases your risk of such an allergy. Foods high in salicylates include blueberries, apples, avocados, mushrooms, cauliflower, parsnips, sweet potato, tea more than coffee and some herbs (basil, bay, chilli, nutmeg, cumin, cloves, ginger, turmeric), as well as other things too. Do not despair – it is possible to have a healthy and nutritious diet even without these ingredients!

Look After Your Nasal Cavities

Keep your nasal cavities free from infection and accumulating mucus. Using a saline nasal spray regularly can help with this, as will an irrigation rinse. Wash your hands frequently and try to limit touching your nose.

See an ENT Professional – Such as London ENT

If you are suffering from sinus allergies and sinus infections frequently, you should see an ENT specialist. Booking a consultation with an ENT professional, such as London ENT, is the best way to ensure your sinuses get the care they require.

ENT doctors can assess your symptoms, diagnose your allergies or condition and advise on the correct treatment. You should let them know any home remedies you have tried, a list of your symptoms and when they occur and anything you have noticed regarding dietary influence. They may advise some lifestyle changes or prescribe some medicine.

Recurring sinus infections are unpleasant and can impact your mental and physical health. You must consult a professional to ensure there is no underlying condition causing your sinuses to give you issues.

London ENT provides a variety of ENT treatments. Contact us on 0203 8657225.


Cholesteatoma – All You Need to Know

Issues with the ears can be stressful, painful and unpleasant. A cholesteatoma is no exception. Here we look at everything you need to know about cholesteatomas.

What is a Cholesteatoma?

A cholesteatoma is a benign skin growth that forms in the middle ear, usually growing behind the eardrum. It is often in the form of a cyst that sheds old skin, which in turn can lead to severe ear and hearing issues.

What Causes a Cholesteatoma?

The Eustachian tube joins the middle ear to the back of the nose in order to regulate air pressure between the outside world and the middle ear. If it is not functioning properly, the pressure in the middle ear reduces and the ear drum can weaken, resulting in a build up of skin cells that can eventually accumulate into a cholesteatoma. The reasons for ineffective functioning of the Eustachian tube include repeated sinus or ear infections, colds or allergies. Repeated middle ear infections are another but less common ause of a cholesteatoma.

Cholesteatoma in children

Although rare, a child can be born with a cholesteatoma. This may not present issues for some years. Factors that put babies at risk of  cholesteatomas include genetic abnormalities, Down’s syndrome, a cleft palate and craniofacial defects.

Cholesteatoma Symptoms

A cholesteatoma can remain symptomless for many years before mild symptoms occur. The main symptoms are:

  • Hearing issues
  • Discharge from the ear
  • An ache or discomfort behind or inside the ear
  • Feeling of pressure in the ear
  • Balance issues and, in severe cases, vertigo
  • In rare cases, facial weakness

If the cholesteatoma becomes infected, symptoms will include inflammation and fever, which require immediate medical attention.

Diagnosis

Your GP or ENT specialist will use an otoscope to check inside your ear for accumulation of skin cells, a abnormally shapred ear drum or evidence of a cyst. Sometimes a CT scan is required. Almost always you will also need a hearing test.

Treatment

A cholesteatoma will not go away by itself, and therefore seeking treatment as soon as symptoms arise is important. The only way to treat a cholesteatoma is with surgery. Antibiotics will often be prescribed initially to reduce the inflammation and keep the area as clean as possible in preparation for surgery.

The surgery involves an inpatient procedure performed under general anaesthetic. The aim is to remove the cholesteatoma entirely in the initial surgery. Follow-up surgery is occasionally  performed to reconstruct the bones of the middle ear in order to improve hearing, or to remove any residual cholesteatoma that has regrown.

London ENT provides a range of specialist ENT treatments and consultations. Contact us on 0203 8657225.


Haemophilus Influenza – All You Need to Know

Haemophilus Influenzae – What is it?
Haemophilus Influenzae is a bacterial infection that can have several serious health implications. Haemophilus Influenzae type b infection is more common in children. However, it can affect people of any age. It is caused by the spread of Hib bacteria in the body, potentially leading to some severe health problems. These include:
• Meningitis
• Pneumonia
• Infections in the lungs, joints, heart lining, skin tissues, bones and windpipe
• Blood poisoning.

Haemophilus Influenzae is now rare in the UK. Immunisation was introduced in 1992, and it now affects less than 1/100,000 children.

Symptoms of Haemophilus Influenzae
As meningitis, pneumonia, and bloodstream infection are the main conditions caused by Haemophilus Influenzae, we will look at those symptoms.

Meningitis
• Temperature
• Frequent vomiting
• Headaches
• Rashes that do not fade
• Drowsiness
• Light sensitivity
• Seizures

Pneumonia
• Breathing difficulty
• Coughing
• Chest pain
• Temperature
• Increased heartbeat
• Fever – shivering and sweating

Bloodstream infection
• Fever or chills
• Low temperature
• Diarrhoea
• Vomiting
• Nausea
• Fatigue
• Feeling week
• Blotchy skin
• Increased heartbeat

How Does Haemophilus Influenzae Spread?
As with many bacteria, Haemophilus Influenzae is passed from those infected onto others. Bacteria in the air can be inhaled if a person is in close contact with someone who is infected. Those vaccinated are equipped to fight the infection, but unvaccinated people will be vulnerable to the condition. Babies often contract the disease in hospitals shortly after birth. It typically takes four days for symptoms to show once a patient is infected with Haemophilus Influenzae.

Vaccinations are the best way to protect yourself against Haemophilus Influenzae. If you are aware of anyone displaying symptoms listed above, ensure you keep a distance. Frequently washing your hands and cleaning surfaces are also good practices.

Treating Haemophilus Influenzae
It is essential to seek help and advice if you or your child are displaying any of the symptoms linked to Haemophilus Influenzae. Treatment will depend on the severity of the illness and the patient’s symptoms.
Antibiotics are an effective method of treatment if the illness is not causing life-threatening issues.
If you have symptoms relating to the ears, nose and throat, you can consult an ENT specialist, such as London ENT. Trained professionals are at hand to help you get the most suitable treatment.

To find out about the ENT services offered by London ENT, contact us on 0203 8657225.


Aspirin-Exacerbated Respiratory Disease – All You Need to know about AERD

Over-the-counter painkillers are used by millions of people daily to treat mild pain and symptoms. Headaches, joint pain, toothache and menstrual pain are just some common reasons people use pain relief tablets, such as aspirin.

However, some people have a condition known as Aspirin-Exacerbated Respiratory Disease (AERD). This condition could leave the patient feeling worse after taking painkillers. Read on to find out all you need to know about AERD.

What Causes Aspirin-Exacerbated Respiratory Disease?

AERD is brought on by sensitivity to NSAIDs (non-steroidal anti-inflammatory drugs). The symptoms of this condition will begin quickly after the medicine is consumed, and the severity of symptoms will vary.

It is not known why some people suffer from AERD when others do not, but some research suggests smokers and those around second-hand smoke are at higher risk. People are usually first alerted to this condition between the age of 20 – 50.

Symptoms of Aspirin-Exacerbated Respiratory Disease

As with most conditions, symptoms of AERD will vary between sufferers. Some of the most common ones include:

  • Asthma symptoms
  • Sinus issues
  • Nasal congestion
  • Persistent nasal polyps
  • Red eyes
  • Watery eyes
  • Sneezing and sniffing
  • Stuffy nose
  • Coughing
  • Chest tightness
  • Wheezing

Less common symptoms include:

  • Nausea
  • Dizziness
  • Fatigue
  • Cramps
  • Loss of sense of smell
  • Persistent sinus infections

Diagnosing Aspirin-Exacerbated Respiratory Disease

No blood test can confirm AERD. Your ENT specialist will likely check to see whether you might also have nasal polyps and asthma, conditions which can also occur with aspirin sensitivity. When all three conditions exist at the same time (aspirin sensitivity, nasal polyps and asthma), a condition known as Samter’s triad is said to exist. Your ENT specialist may arrange an aspirin challenge, which involves the patient taking aspirin while supervised and assessing the results. However, this is not suited to those with confirmed asthma, liver, kidney or heart disease or pregnant people.

 

Treating Aspirin-Exacerbated Respiratory Disease

While this is no exact cure for AERD, several treatment options are available to help manage the symptoms. Steroid sprays and sinus rinses are effective options which can reduce inflammation and give symptomatic relief. In some cases, more powerful steroid preparations may be needed, such as oral tablets or an injection, which can help to shrink the size of nasal polyps.

There is also a process in which a patient can desensitise to the effects of NSAIDs. This involves consuming gradually increasing doses of aspirin daily, under close medical supervision, until symptoms occur. This helps to assess the dose that triggers AERD. A dose just below this is then maintained which helps to build immune tolerance to the NSAID. Such a process is normally conducted in specialist centres in the UK, as not all clinics operating on their own can offer this treatment. Speak with an ENT specialist, such as London ENT, to find out the best treatment plan for you.

To find out about the ENT services offered by London ENT, contact us on 0203 8657225.


How To Combat Allergies In The Colder Months

Autumn and winter can cause problems and discomfort for many people who suffer from allergies. The days are shorter, colder and darker, and the air is damp. Here we look at the ways you can overcome allergies this autumn and winter.

Allergy Medication

Over the counter allergy medication can help to ease symptoms caused by allergies. This includes a runny nose, watering eyes, coughing, sneezing and wheezing. Consult an ENT specialist, such as London ENT or your GP if you are unsure which medication is best for you.

Allergy Injection

Some people opt for allergy shots. These injections suppress your immune system to control your allergy symptoms. They are more commonly used for severe seasonal hayfever and are rarely required in the winter months as the risks tend to outweigh the benefits. Talk to your GP or an ENT professional if you would like further information.

Nasal Sprays

A variety of nasal sprays are available, most of them include a small dose of steroid. While nasal sprays are proven to be highly effective at treating allergy symptoms, they may also cause side effects. These include headaches, bleeding, and more rarely nausea, stomach upset and dizziness. Steroid nasal sprays can be purchased over the counter although some require a prescription.

Regularly Wash and Sanitise Your Hands

Pollen, dust, dander and mould spores are among the most common allergens. If these things are in your home, they can cause symptoms such as sneezing, wheezing and coughing. Washing and sanitising your hands frequently will help to limit your contact with these allergens. This is particularly important for pet allergies.

Up Your Cleaning Game

Dust mites, mould spores and dander, are common in homes. These allergens are prevalent in the colder months, so ensuring you have a thorough cleaning routine is important. Wash bedding weekly and ensure all surfaces are wiped down after use. An air purifier is also helpful. If you notice any signs of mould, tackle it immediately. Extractor fans can help to reduce moisture that causes dampness and mould.

Avoid Pets

Cats, dogs, guinea pigs, and even birds can all trigger allergy symptoms. Avoid places that have pets where possible and if you have a pet in your home, make sure you hoover any hairs. If allergy symptoms are severe, then you may have to consider rehoming your pet. It is also sensible to exclude any pets from your bedroom.

Allergies can cause symptoms that can severely impact your physical and mental health. Following these tips above will give you the best chance of beating this problem in the autumn and winter months.

For information about the specialist ENT consultations and treatments we offer at London ENT, contact our friendly team on 0203 865 7225.


Everything you Need to Know About The LATERA Absorbable Nasal Implant

What is The LATERA Absorbable Nasal Implant?

The LATERA Absorbable Nasal Implant is a small implant for the nose and is used to support the cartilage and reinforce the sidewall of the nose. It sits inside the lateral nasal wall to support the lower and upper nasal cartilages, helping to treat nasal airway problems and improving breathing for the patient. The implant is made from a polymer that slowly absorbs over the course of around eighteen months.

The LATERA Absorbable Nasal Implant could slightly alter the shape of the patient’s nose, but this will vary from person to person. It will certainly not be a noticeable change, and people will not be able to tell you have the implant fitted.

It has been regularly used in the USA over the last few years and will shortly be available in the UK.

 

Symptoms that could indicate The LATERA Absorbable Nasal Implant is suitable for you

The LATERA implant is best suited for patients who have a weak sidewall of the nose which appears to collapse easily when you breathe in. There can be a number of medical causes of this, such as a natural weakness due to ageing, and/or previous trauma or injury to the nose (including previous nasal surgery). Sometimes, having a problem inside the nose that can affect your breathing, such as allergy or a deviated nasal septum, can also restrict the nasal passage and make the sidewall weaker. If this is the case, these issues will need to be addressed first and a formal examination taken by your ENT specialist should take place in order to identify these and any other issues so that they can be appropriately managed before considering the suitability of the LATERA implant.

If you are experiencing any of the following symptoms, it could be The LATERA Absorbable Nasal Implant is the right option for you. Speak with an ENT specialist, such as London ENT, to arrange a consultation and discuss symptoms and treatment.

  • Nasal congestion
  • Stuffy nose
  • Blocked nose or nasal obstruction
  • Difficulty breathing through the nose
  • Sleep issues caused by nasal discomfort
  • Trouble breathing through your nose when exercising

 

How is The LATERA Absorbable Nasal Implant fitted?

The LATERA implant is secured just above the bone of the upper sidewall of the nose, and a small extension of the implant runs towards the lower part of the nose, ending up just above the lower nasal cartilage. It prevents the wall of the nasal cavity from collapsing inwards when you breathe in. The patient may have one implant on one side of the nose or one in both sides. The procedure is fast, simple, effective and usually undertaken under a local anaesthetic, although a general anaesthetic may be required in some people, especially if you require other procedures to be performed at the same time. This is a minimally invasive treatment, as opposed to surgical operations such as septoplasty or rhinoplasty. The LATERA Absorbable Nasal Implant can also be removed if required.

 

Are there side effects with The LATERA Absorbable Nasal Implant?

Any surgical procedure carries with it the risk of certain possible risks and complications, although in the vast majority of cases the benefits of The LATERA Absorbable Nasal Implant far outweigh the potential side effects. Patients may experience mild facial bruising, discomfort, inflammation and minimal bleeding. These symptoms should be temporary and usually improve within one to two weeks. Consult your ENT specialist if these symptoms persist or if you show signs of an infection, although this is very rare.

For information on the specialist ENT treatments and consultations, we offer at London ENT, contact our friendly team on 0203 8657225.


ClariFix Cryotherapy – All You Need to Know

What is ClariFix Cryotherapy

ClariFix Cryotherapy is a relatively new procedure that involves freezing a small area at the back of the nose that has become inflamed. This is a minimally invasive procedure done using a cooling probe. It is a safe and clinically proven treatment that provides long-lasting relief from the symptoms of conditions such as chronic runny nose, congestion and rhinitis.

How Does ClariFix Cryotherapy Work?

Patients suffering with rhinitis (inflammation of the lining of the nose) often describe symptoms of a runny nose, nasal congestion, itching and sneezing, many of these symptoms can be treated adequately with conventional medical treatments such as nasal sprays and drops, and also antihistamine tablets if there is an allergy. However, in some cases symptoms may persist, in particular a runny nose which can be troublesome to treat.

The ClariFix probe is inserted into the back of the nose and gently freezes the nerve endings that are responsible for producing excessive mucus and nasal discharge. During the procedure you may experience mild pressure and a cooling sensation during the treatment, and in rare cases you might get a more intense ‘ice cream’ type headache, but any discomfort should be short-lived.

The Benefits of ClariFix Cryotherapy

  • Minimally invasive procedure
  • Treatment generally lasts less than ten minutes
  • Treatment can be done in-office or under local anaesthetic in theatre
  • Treatment goes directly to the cause of the issue
  • Minimal recovery, with many patients resuming normal activities within a couple of days
  • Reduction in symptoms such as runny, drippy, or stuffy nose, post-nasal drip, congestion and sneezing
  • Suitable for patients who have already tried tablets, drops and sprays, and which have not been effective
  • Many patients report all symptoms are gone or significantly reduced within two to six weeks of the procedure.
  • Results usually last at least a year – in some cases the procedure does need to be repeated, however as it is minimally invasive with little recovery, most people do not find it too inconvenient
  • Significantly improves day-to-day life, confidence, mood and even sleep.

Possible Side Effects

Some patients report a slight increase in congestion straight after the treatment, but this subsides quickly. You may feel discomfort and irritation in the nose temporarily, and in some rare cases, facial pain, bleeding of the nose and headaches may occur. If so, consult an ENT specialist, such as London ENT.

Chronic Rhinitis – What is it and What Causes it?

Chronic rhinitis is the primary reason people require ClariFix Cryotherapy. Chronic rhinitis refers to symptoms caused by nerves in the nose that are unbalanced. The symptoms are:

  • Blocked nose
  • Runny nose
  • Sneezing
  • Nasal itching
  • Post-nasal drip
  • Congestion

If treatments such as antihistamines, sprays, and pills do not help the issue, it is time to consult an ENT specialist. ClariFix Cryotherapy has been in regular use in the USA for several years, and is now available in the UK. It is likely to become an increasingly popular solution to relieve the symptoms of chronic rhinitis.

For information on the specialist ENT treatments and consultations available from London ENT, contact our professional team on 0203 865 7225.


Chronic Rhinitis – All You Need to Know

What is chronic rhinitis?

Chronic rhinitis is a long-term inflammation of the inner nose lining. If your rhinitis symptoms persist for more than four weeks, it is considered to be chronic rhinitis. There are many possible causes of rhinitis, including triggers that can irritate or inflame the lining of the nose, or a neural (nerve-related) imbalance which results in an influx of signals to the inner nose, causing the nose to swell and produce a lot more runny discharge than usual.

Symptoms of Chronic Rhinitis

  • Runny nose
  • Stuffy or blocked nose
  • Itching of the nose
  • Persistent urge to sniff
  • Nasal congestion
  • Post-nasal drip
  • Coughing

Causes

Chronic rhinitis is caused by over-stimulation of the nose. Things that could trigger this include:

  • Allergies – Hay fever, dust allergies.
  • Irritants – Second-hand smoke, some perfumes, fumes.
  • Weather changes – Humidity or very hot weather.
  • Dietary factors – Food sensitivities can develop at any age and may trigger an allergic reaction. Spicy food and alcohol are both known to irritate the lining of the nose.
  • Medications – If you notice the symptoms of rhinitis after beginning a course of new medicines, you should stop taking this medication and consult your doctor.
  • Other health conditions – Viral infections such as a cold or the flu, sleep apnoea, acid reflux, chronic fatigue syndrome, diabetes.
  • Hormonal changes – This includes pregnancy, menstruation, contraceptive use and menopause.

Complications

There are a few complications that can arise from long-term chronic rhinitis. These include:

Nasal polyps – These benign lumps form in the nose lining or sinuses and are caused by long-term inflammation. They can block the airway and hinder breathing.

Sinusitis – Sinus infections can flare up due to the continued irritation of the lining of the nose and sinuses.

Impacting on day-to-day quality of life – Chronic rhinitis can disrupt your daily activities and affect your mental health. It can reduce your productivity and make you feel tired due to lack of sleep.

Treatments

There are several ways of treating the symptoms of chronic rhinitis. The best thing to do is to have a consultation with an ENT professional, such as London ENT, to determine the best treatment for you.

Treatment options include:

  • Nasal sprays
  • Nasal drops
  • Anti-allergy medications (antihistamines)
  • Saltwater nasal rinses/douching
  • Steam inhalations

 

If your symptoms continue despite the above treatments, there are some surgical options available, although these are not suitable or appropriate in all cases. Surgical options include trimming the lining of the nose either by cauterisation to the inferior turbinates, or coblation. Occasionally surgical reduction might need to be considered.

There are also some new minimally invasive treatments becoming available soon which involve cryotherapy to the nerves in the nose responsible for the production of the majority of the internal nasal swelling and nasal discharge. ClarifixTM is one such treatment and can be undertaken under a local anaesthetic, sometimes with sedation.

For information on the specialist ENT treatments and consultations we offer at London ENT, contact us on 0203 865 7225.


Vestibular Migraine – The Facts

What is Vestibular Migraine?
Vestibular migraine, or VM, is a migraine that causes dizziness. Dizziness is a common migraine symptom, with most sufferers experiencing some form of dizziness either directly before or during their migraine.

Symptoms
• Visual issues – Flashing lines, zig-zags.
• Dizziness or a spinning sensation (vertigo) – This usually lasts several hours although can go on for days
• Nausea
• Light sensitivity
• Sound sensitivity
• One-sided, pulsing headache
• The need to lie down in a dark room
• Tinnitus – this is a less common symptom but has been reported in up to 1/3 of patients
• Less commonly, a numbness or tingling sensation in various parts of the body
• Less commonly, trouble with speech can occur, which can last anywhere from 5 to 60 minutes

Diagnosis
Diagnosis largely depends on the individual sufferer’s history as there is currently no test that can identify the condition. Your GP, ENT specialist or neurologist can run through your symptoms and family history to help assess your health.

The symptoms of VM can overlap with other inner ear conditions, such as vestibular neuronitis or more rarely Meniere’s disease, although in the latter case you would usually expect to see symptoms of hearing loss, with a documented reduction in hearing on hearing assessment, and tinnitus in most cases. In vestibular migraine, the hearing is almost always normal.

Causes
It is not always understood why a person may suffer from VM. Some of the common causes or triggers are similar to those for migraines in general, and include:
• Rapid head-turning
• Having your head in a particular position
• Certain foods or drinks (Caffeine, dark chocolate)
• Hormonal issues, such as periods or HRT
• Stress
• Lack of sleep
• Excessive use of screens – computers, mobile phones, films
• Exercise
• Flashing Lights
• Family history of migraines

Investigations
After a thorough examination, you may require some blood tests, as well as a formal hearing assessment. In some cases, a scan might be needed, such as a MRI scan of the inner ear and brain, to help rule out other possible causes.

Treatment
Painkillers can be taken to help reduce the acute headache, such as paracetamol or ibuprofen, assuming you are not allergic to them. The vertigo symptoms are less likely to respond to medications although in some instances you may need a prescription for a vestibular sedative such as prochlorperazine (stemetil) if the symptoms are very bad and/or persistent. Alternatively, an anti-sickness type medication can be helpful for more persistent, milder symptoms, for example, cinnarizine, which can be obtained over the counter in most pharmacies. Ultimately, if the attacks of dizziness are linked to migraine-type headaches, you may require specific advice to treat the current migraine attack and prevent future attacks from occurring. Your ENT specialist may recommend a review by a neurologist for further more specific treatment of the migraine.

Prevention
The best way to prevent future VM attacks is to identify the root cause. If a particular food or drink seems to trigger it, eliminate this from your diet.
Some preventative medications can be tried, such as amitriptyline and propranolol. Speak with your ENT specialist to establish which medication or form of prevention is best suited to you. There may be side effects to these medicines which should be discussed and considered.
Vestibular migraines are rarely a sign of something more serious, but your symptoms should never be ignored.

Be sure to consult an ENT professional, such as London ENT, for advice. For more information, contact London ENT on 0203 865 7225.