DR.CHITALE ENT HOSPITAL
ENT AND HEAD & NECK CENTRE


Vertigo and Balance Center


An expert diagnostic and treatment centre


Dizziness is a complex symptom and finding its exact cause remains to be a challenge. So in May 2014 a center for evaluation of dizziness was founded by Dr. Vinaya Chitale, an American Board certified ENTin collabration with American trained Neurophysiotherapist and Vestibular Rehabilitation Specialist Dr. Saloni Raje (PT).

Defeat Dizziness – Restore Your Balance Regain your Independence !!

Our Goal:

To provide a cost effective international treatment to our patients.

Our Mission : To improve quality of life of people affected by dizziness by providing information, support and education.

Our values : We are experts in this field who are constantly learning and growing and we strive to collaborate multidisciplinary


What is dizziness?

Dizziness is a general term used to describe a feeling when something is wrong with one’s sense of balance.

What is vertigo?

Vertigo is used to describe spinning sensation

What is the incidence?

About 40% of our population over 40 years is affected with dizziness. Amongst those 45% is caused by problems with balance systems located in the inner ear.

Is vertigo a serious disease?

Vertigo is not a serious or life- threatening condition, however it causes discomfort in doing everyday activities and results into loss of self confidence since it affects every movement of the body. Long standing dizziness can result into secondary symptoms such as muscle fatigue; depression and can affect personal, financial and social life.

What are the causes of vertigo?

Dizziness or vertigo is a very complex symptom that can be arising from variety of conditions. Some medications can have dizziness as a side effect. But in majority of the cases vertigo or spinning arises because of problems in the inner ear. The sensation of being off balance can also be due to vision problems or problems in movement and position detectors (proprioception) in our joints and muscles. In rare cases dizziness can also be caused by anxiety, low blood pressure, neck spasm, migraine, reduced blood supply to balance center in the brain, after head trauma. It can also occur in some central neurological disorders like parkinsonism, multiple sclerosis or after stroke.

How do we make a difference?

Our aim is to reduce uncertainty and anxiety by providing clear and accurate diagnosis. By this we can answer all your questions based on current best practice guidelines. Then we design an indivisualised treatment for every patient to improve their dizziness or vertigo.

How do we treat

This is a non-medicated treatment that involves a specialized form of exercise-based regimen called vestibular rehabilitation. The most common type is BPPV that can be cured in one setting more than 95% of the time by performing repositioning maneuver. Early intervention and treatment can lead to quicker functional recovery. In order to develop vestibular compensation you should be off any medication that suppresses the balance system. It is very important for the brain to understand the imbalance between the two vestibular systems. Slowly in about 10-12 weeks the brain copes with the error signals thereby regaining the balance control of the body.

Who should you see first for your dizziness?

You could see your GP first. You can get treated with medications to suppress the balance center in the beginning. However, after a few days see an expert at the balance center to determine the exact cause of dizziness.

When should you go to the hospital as an emergency?

If your symptoms are associated with severe headache, weakness in your arms and legs, fainting, chest pain, facial numbness, slurred speech, double vision go to the nearest hospital.

What can you do to avoid a recurrent attack of dizziness/ vertigo?

Stay hydrated, avoid caffeine and tobacco, keep active, practice yoga, and avoid getting into crowded spaces with lots of people moving about. Looking at a fixed object will improve the vertigo arising from the inner ear.

Do you completely recover from dizziness?

Yes. Don’t suffer in silence. Nearly all people with dizziness and balance problems can make substantial recoveries and carry on with their lives. Medications to suppress your dizziness and sedatives and are only known to prolong your symptoms not cure it. Medications should only be used as initial treatment not as everyday treatment.


Our team:

Our team is highly trained in the field of vertigo evaluation and current treatment protocols.


Dr Vinaya

Dr Vinaya Chitale, MS ENT
Head & Neck Surgery, USA

Dr Saloni

Dr Saloni Raje, MPTh (USA)

Dr dani

Dr Sanket Dani MS ENT , DNB


What are the main parts of the balance system ?

The main parts of the balance system are -

  • i) Balance system in the inner ear called the vestibular system
  • ii) The visual system (our eyes)
  • iii) Movement and position detectors (proprioception) in our joints and muscles

Our brain relies on the information it receives from these systems for any given moment or situation. For example in dark environments it relies on information from the inner ear balance system and proprioception. Alternatively, if you are walking on a rough surface it will rely more on signals coming from eyes and the balance system.Many people retain a good sense of balance despite having inner ear problems due to these compensatory support mechanisms. But if these start failing e.g with age or diabetes the patient’s dizzy symptoms will worsen if their vestibular system is not intact.

What are the parts of the ear?

Ear Parts

The inner ear (labyrinth) consists of a hearing organ (cochlea) and a balance organ (vestibule). The vestibular system consists of otoliths and semicircular canals. The otolith organs are called utricle and saccule. They sense linear acceleration. The semicircular canals lie in three different planes perpendicular to each other and sense angular acceleration. We have three semicircular canals –horizontal or lateral, posterior and anterior. They are C shaped canals and have dilated ends called ampulla. They contain fluid called endolymph that moves with head movement. The sensory organs in vestibular system sense the direction of movement. The sensory organ in the ampulla is called cupula whereas the sensory organ in the otolith is called macula.Vestibular system is the main sensory system of our body that provides sense of balance and spatial orientation to the brain to maintain balance. Any difference in the in the incoming impulses from the two sides by brain will lead to a sense of imbalance


Sometimes in patients with history of head trauma or in women with osteoporosis free floating particles called otoconia made up of calcium carbonate crystals develop in the utricle. They can then migrate into the semicircular canals causing disturbance of endolymphatic flow leading to a whirling or spinning sensation that lasts for few minutes. This occurs mostly when the patient is rolling in bed or getting up or looking up or down .This is called BPPV.


What is BPPV?


BPPV is a benign paroxysmal positional vertigo that lasts for few seconds to minutes. Once we identify which canal is affected it can be completely treated by repositioning maneuver.

Is Meneire’s disease very common?

Meneire’s occurs in about 1 in 100 dizzy patients. It consists of spinning for hours to days, aural fullness, tinnitus and loss of hearing on the side of the lesion. We have designed a non medicated treatment approach that consists of intratympanic high dose dexamethasone for mild cases to prevent hearing loss and low dose gentamicin injection for severe cases with sensorineural hearing loss.

What are the goals of Vestibular Rehabilitation?

  • i) To alleviate or resolve patients symptoms to allow the patient to return to full function
  • ii) To identify and discontinue all medications that can lead to dizziness
  • iii) To reduce the risk of falls and injury
  • iv) To provide education and emotional support to the patient and family members that will aid in prevention of reoccurrence of his or her symptoms.

What can be treated with Vestibular rehabilitation?

  • i) Benign Paroxysmal Positional vertigo is the most common
  • ii) Vestibular neuronitis, labyrinthitis, inactive Meniere’s disease, post surgical ablation
  • iii) Ototoxicity, Diabetes, Aging
  • iv) Central balance disorders- After/Post, CVA, head injury, tumors.

What are the common signs and symptoms that will Improve with Balance Therapy?

  • i) Dizziness
  • ii) Spinning
  • iii)Motion sensitivity
  • iv)Imbalance and frequent falls
  • v)Tinnitus
  • vi)Aural fullness / Fullness in the ear
  • vii)Neck pain
  • viii)Headaches

What are the Secondary Symptoms that develop if Vestibular Disorder is not Treated?

Decreased muscle strength, loss of range of motion and increased tension in and around the joints of the neck and shoulder regions. This can further result in headache, muscle fatigue and degenerative changes within the cervical spine commonly referred to as "cervical spondylosis." This can further lead to difficulty at work and loss of confidence in self and growing dependency on others.

What’s coming up ?

We are introducing the innovative Balanced Body Pilates system for mind- body exercise in April 2017. We feel that awareness of one’s own body and spine is critical in maintaining balance.
It is a safe and sensitive exercise system that improves –

  • i) Strength and Flexibilty
  • ii) Awakening of dormant muscles and brain cells thereby improving co-ordination
  • iii) Increases postural stability and alignment

All this is key in having a balanced body! This increases the joy of living and it can be experienced by anybody from young to the old.


Pilates in Pune

How does pilates help in improving balance?

  • i) It enhances correct spine and pelvic alignment so you actually learn to control its movement which plays a key role in body movements
  • ii) It develops a strong "core" or center of the body. The core consists of deep abdominal muscles along with muscles closest to the spine. Control of core results into better balance.
  • iii) It conditions the whole body and the entire musculature thus improving muscle elasticity. This increases joint mobility and such a balanced body is less likely to get injured due to loss of balance.

Who can benefit from pilates ?

Pilates will benefit-

  • i) Patients with back pain/ neck pain/ shoulder pain
  • ii) Athletes – swimmers, runners, badminton players, tennis players .
  • iii) Young hard working people to develop better posture who do not get time to do regular exercise.

You have to try atleast 3 sessions to notice a difference in your body dynamics.

Maintaining balance is a complex function although the ear is a very important component other factors also play a role. To have a good sense of balance we need to be able to judge where we are and be aware of the position of certain key parts of our body like the spine in relation to the other parts of the body and to the world around us !