Comprehensive Vestibular Assessment and Treatment at Liverpool Hearing Centre

Your Comprehesive Vestibular Assessment will include a combination Of The Following:

Service Description
Medical Questionnaire Initial assessment tool for patient history and symptoms
Physical Examination Thorough evaluation of balance and hearing health
Otoscopy & Microsuction Detailed ear examination and wax removal
Hearing Test & Tympanogram Assessment of hearing ability and middle ear function
HINTS & VOMS Testing Advanced diagnostic techniques for vertigo and balance issues
Caloric, Dix-Hallpike, & Supine Roll Tests Specific procedures for diagnosing BPPV and other disorders
Epley/Gufoni Maneuvres Effective treatment methods for positional vertigo
Diet & Exercise Advice Guidance for lifestyle adjustments to manage symptoms
Referral Suggestions Professional recommendations for further medical consultation

Your Journey to Better Balance Begins Here

The Liverpool Hearing Centre offers a thorough and holistic approach to diagnosing and treating balance disorders. Our process is designed to comprehensively address each aspect of vestibular health.

Initial Assessment

  • Medical Questionnaire: Your first step in vestibular assessment, where we gather detailed information about your medical history and symptoms.
  • "Physical" Examination: A thorough check to understand your balance and hearing health.

Detailed Ear Examination

  • Otoscopy and Ear Wax Microsuction: We carefully examine your ears and, if necessary, perform gentle microsuction to remove wax, ensuring clear pathways for accurate testing.
  • Hearing Test and Tympanogram: These tests evaluate your hearing levels and the health of your middle ear, which is crucial for diagnosing balance-related issues.

Advanced Diagnostic Techniques

  • HINTS & VOMS Testing: Specialised tests to diagnose vertigo and balance disorders.
  • Caloric Test, Dix-Hallpike Test, and Supine Roll Test: Specific diagnostic procedures to identify conditions like BPPV and other vestibular disorders.

Personalised Treatment and Advice

  • Epley or Gufoni Manoeuvres: Depending on your diagnosis, these repositioning manoeuvres are performed to treat positional vertigo.
  • Diet and Exercise Advice: We provide tailored recommendations to help manage your symptoms through lifestyle changes.
  • Referral Suggestions: If needed, we will suggest further medical consultations to ensure comprehensive care.

Effective Vestibular Diagnosis & Treatment at Liverpool Hearing Centre

At Liverpool Hearing Centre, we pride ourselves on our meticulous and effective diagnostic approach to vestibular disorders. Each step in our process is designed to uncover the underlying causes of balance and hearing issues, ensuring precise and effective treatment plans.

Enhanced Otoscopy and Microsuction

  • Video Otoscopy: We employ advanced high-definition video otoscopy techniques to examine the ear in detail, identifying any abnormalities that may contribute to vestibular disorders.
  • Safe Microsuction: Under a microscope, our technique of ear cleaning is the gold standard for removing obstructions like earwax and ensuring other diagnostic tests are as accurate as possible.

Comprehensive Hearing and Tympanometry Tests

  • Detailed Hearing Assessment: Our hearing tests are not just about measuring hearing levels; they provide insights into how hearing health relates to balance disorders.
  • In-depth Tympanometry: This test evaluates middle ear function, which is crucial for diagnosing conditions affecting balance and hearing.

HINTS & VOMS Assessments

  • HINTS Protocol: This test is vital for differentiating between central (brain-related) and peripheral (inner ear-related) causes of dizziness, guiding our treatment strategy.
  • VOMS Assessment: It gives a comprehensive picture of how the vestibular and ocular systems interact, which is essential for understanding balance disorders.

Specialised Maneuvers and Tests for Accurate Diagnosis

  • Caloric, Dix-Hallpike, and Supine Roll Tests: These specific tests allow us to diagnose BPPV and other vestibular disorders with high precision. 
  • Epley and Gufoni Manoeuvres: Performed based on diagnostic findings, these manoeuvres are crucial for treating positional vertigo effectively.

    Through this detailed and patient-focused approach, we ensure that every aspect of your vestibular health is thoroughly evaluated, leading to an accurate diagnosis and an effective treatment plan.

Tailoring Treatment to Each Patient

Our Balance Care Philosophy at Liverpool Hearing Centre

Our first priority at Liverpool Hearing Centre is to rule out any audiological issues. Then we can move on to checking whether the vertigo is from a central cause or from an acute peripheral vestibulopathy


In simple terms, the main difference between a central cause of vertigo and an acute peripheral vestibulopathy lies in where the problem originates within your body.

  1. The term "central cause of vertigo" refers to vertigo (a feeling of spinning or dizziness) that results from a problem with the central nervous system, such as the brain or brainstem. It can be due to various neurological conditions or disorders affecting the brain's balance centres. Central causes of vertigo often have more serious underlying issues and may be associated with other neurological symptoms.
  2. Acute peripheral vestibulopathy: This refers to vertigo that arises from a problem in the peripheral vestibular system, which includes structures like the inner ear. Common causes include conditions like benign paroxysmal positional vertigo (BPPV), Meniere's disease, or vestibular neuritis. Peripheral vestibulopathy usually involves issues with the balance organs in the inner ear and is generally less severe than central causes.

In summary, the key distinction is that central causes involve problems within the central nervous system, while acute peripheral vestibulopathy originates in the peripheral balance system, typically within the inner ear. Central causes tend to be more complex and serious, while peripheral vestibulopathy is often more treatable and less concerning. All central causes will be referred to another specialist.


Most peripheral vestibulopathies can be treated at Liverpool Hearing Centre. We will focus on creating individualised treatment plans for each patient. This tailored approach ensures that every aspect of the patient's condition is addressed, leading to more effective management and improved outcomes.

We provide one comprehensive dizziness and balance assessment:

Neuro-Vestibular Assessment


  1. Medical & Physical Assessment
  2. Medications & Supplements Review
  3. Video Otoscopy
  4. Hearing Assessment
  5. Tympanogram
  6. HINTS & VOMS Oculomotor Tests
  7. Caloric Test
  8. Dix-Hallpike Test
  9. Supine Roll Test
  10. Epley Manoeuvre/Gufoni Manoeuvre
  11. Diet Advice & Exercise Advice
  12. Referral suggestions


Vestibular Follow-Up