Episode: 2109
Title: HPR2109: Hacking my inner ear
Source: https://hub.hackerpublicradio.org/ccdn.php?filename=/eps/hpr2109/hpr2109.mp3
Transcribed: 2025-10-18 14:24:35

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This in HPR episode 2109 entitled Hacking Mytheria, it is hosted by Dave Morris and in about
15 minutes long, the summer is how I discovered some new things about how mytheria works and
how to stop falling over.
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Hi everyone, this is Dave Morris, I'm going to do a slightly unusual show today or episode
where we want to call it because we're very short of episodes in the queue.
I'd had this one in my list of possible for over a year now and I'd more or less just missed
it as not being appropriate but given that we're quite desperate, you're going to get it.
So what I'm talking about today is I've entitled anyway Hacking Mytheria.
So I'm seeing it as a bit of a hacking exercise you decide whether you agree or not.
What motivated me to do this was in April 2015 I suddenly found myself getting really dizzy
as I've bent down when I was having a shower actually and I pretty much fell over as a consequence.
Just about managed to save myself and didn't hit my head on the wall or something scared me.
I meant to see a doctor but since it was a weekend I got a sort of emergency guy and he wasn't really
able to diagnose it. Within a day or so a medical student I know, I don't think I'm allowed to tell
you who it was but that medical student is now fully qualified doctor and is doing her
foundation training in various hospitals and so on. She suggested that it might be something
called BPPV which stands for benign, paroxysmal, positional vertigo and with that in mind I researched
and found out a lot more about it and got myself a cure. Now, first of all, apologies because I'm
going to be talking about a certain number of medically technical things. Try to keep that to a
minimum. Secondly, disclaimer, I'm not medically trained. Just an interest as observer happens to
have a science education, got a degree in biology so the stuff I'm going to talk about if you
experience any of it yourself then seek medical advice. You need to find out whether it actually
is BPPV or something else and you need to get qualified assistants to deal with it.
So let's talk a bit about the human inner ear or actually the mammalian in it because they're
pretty similar across all mammals I believe. As a young student I was not sure whether I wanted to
go into biology or medicine. I quite fancied the idea of medicine but I wasn't quite sure that I
had the, I don't know really, I was brave enough to do it I suppose. I'm sad I didn't make that
choice but they go. But at that point I got very interested in the structure of the human inner
ear and studied it quite a lot as I was preparing for my A level zoology examination. It was on
the curriculum but I went into much more detail than was necessary. I got a question on it in the
A level exam and was able to write a lot. In fact I had to control myself otherwise I've been writing
you know on that for the entire time. I got a a good mark as a consequence I'm pretty certain.
So the human inner ear performs two major functions. It's got a thing called the cochlear
which is the bit that handles hearing. It's a bit of a simplification but forgive me I'm sure.
And the other bit is called the vestibular system and it's concerned with balance. So I'll skip
over the hearing bit in this episode. It's really fascinating. I'm amazed how it works. I'd
love to talk about it but it's probably not on on the HPR. As a tinnitus sufferer I get whistling
in my ears. It's fascinating how it malfunctions as you get older as well. I'm going to concentrate
on the vestibular system and in order to give you some sort of insight into the BPPV condition.
So I put a diagram in my long notes as long notes for this because otherwise it would be too long
for the RSS feed. Many of the texts that you look at and the ones I looked at when I was studying
this back in the 70s show pictures of a structure with the curly cochlear and the
the semi-circular canals and stuff. You'd get the impression from that that there is a sort of
thing you can take out of a of a skull which is this structure. It's not true. What it's actually
showing is a series of cavities within the sort of solid bone, the temporal bone of the skull.
So it's tubes. It's not a structure that you can remove per se. That's my understanding. I've
never dissected a human head. They're dissected a number of other heads and I don't believe. We
didn't look at that particularly, but anyway, various cavities and passages that make up this
structure are fluid filled with fluid called perilymph which is worth mentioning because it's part
of the cerebral spinal fluid that is in your spine and around the in your skull and
both brain. And inside each of the tubes there's a membranous tube or membranous structures that
many of them are tubes which is filled with another fluid called endolymph. The balance system is a
fairly chunky looking chamber called a vestibule and connected to it. As you can see in the picture
hopefully, there are three semicircular canals. The canals are oriented at right angles to each
other and are responsible for sensing rotational movement of the head and I put down here pitch
roll and yore because if you understand those terms in the sense of flying a plane or a
modern plane or something, it's the sort of X, Y and Z axis rotation. Now there are five sensory
areas in this structure, in the vestibular structure and each of the semicircular canals has a
enlarged region which you can see in the picture which is called the ampulla and in there is a
collection of sensory cells that detect the movement of the internal fluid, the endolymph and the
the movements caused by head rotation. There are two other sensory structures in the vestibule called
and sorry about these names, the sacuille and the utricle and they detect head position,
not so much the movement but the position in relation to gravity. So this is relevant in the
context of this disorder. Now the senses in the vestibule, this succulent utricle, are different
from the others in that they have calcium carbonate crystals attached to them on the top and these
are verishly called otoliths which means earstone, otoconia, I don't know, I can't pass that one,
statoconia is the other name, I didn't look up the Latin of those, I know lithamine stone and otore
relates to ear. Anyway they're acted on by gravity, the weight of these little crystals are
acted on by gravity and they trigger these sense cells to tell you brain what orientation your head
is in. Now here's the important part, it's actually very complicated if you want to look at the
way it's all structured together but I'm trying to simplify it to some degree but one of the things
I think it's quite important is that the utricle is in the part of the inner ear which is connected
to the semicircular canals. The sacuille on the other hand is in a different part of the structure,
it's not connected. So let's talk about BPPV. What happens in this condition is that otoliths
become dislodged from the utricle. Remember it's connected to the semicircular canals and it
migrates it or they migrate into the semicircular canals and there they disrupt the normal process
of sensing head rotation and that's where the vertigo, the dizziness comes from. Now the detachment
of otoliths can be caused by head injury but it also happens spontaneously as you get older.
I'm older therefore it happens spontaneously. Now the BPPV business and I'll try not
to use the full thing but I thought you might find it useful like explain what it actually means
benign. The first word is means that it's not a threat to health it's something that's
an useless more than anything else. Paracysmol is a word, a medicines full of these things.
It a paracysm is a is a brief event in these terms or paracysmol because it occurs in
short bursts and it's positional because it happens when you change your head position in
particular ways and the vertigo bit is because it results in this dizziness or a spinning sensation.
So in my experience there are two common conditions that will trigger about of BPPV and it's
things like suddenly bending down or lifting your head up to look up or turning over in bed. Turning
over in bed is the worst one in my experience anyway. So talk about the semi-circular canals.
They detect head rotation by the movement of the endolimp fluid across sensory cells in the
ampulli. When the head is moved the fluid lags behind because of inertia so you know you suddenly
move quickly with a cup of tea and it spills out of the cup because it doesn't want to move
rapidly as you do. So this fluid movement causes bending of the hairs of these sensory cells.
They're all the sensory cells are all structures that have sort of hair like structure within them
which when they are flexed causes a signal that goes goes along the nerve. The fluid once it's
lagged a bit the fluid catches up the movement and then things stabilize but that process of moving
from still to moving is the process of acceleration and these things detect and they detect which
direction it is by virtue of which one triggers. The dizziness is actually caused by the fluid
movement or the sensor cells themselves being affected by the loose otoliths. Remember we've now
got crystals moving around in the fluid whereas it's designed in quotes to just have fluid moving
around. So this can change the way in which the fluid moves because there's more mass in there
or they can actually stick to the sensor cells themselves and cause that whole mechanism
to work differently. So these changes in the normal behavior of this sensing system causes
sensation of movement when there is none. The other thing is that normally when you rotate your head
your eyes automatically compensate. They do a thing called nistagmas which is they try to keep
distant images in sight so as you move your head you don't lose sight of things that might be
important that leopard about to leap on you or something like that. So during the BPPV where your
head's not actually moving but you think it is then the rotational movement signals are received
in the eyes moves if they would if the rotation was real and this so-called nistagmas is a diagnostic
feature of BPPV. So let's talk about treatment then. So I read up about this stuff at the time when
I experienced it. I found there were a number of procedures that are used to diagnose and treat
BPPV. The simplest form of treatment consists of head movements designed to move the
displaced otoliths from the semi-circular canal back into the vestibule where we won't do any harm.
I don't know what happens to them once they've got back into the vestibule. I've seen some
indications that they might be reabsorbed in some way but this sort of information is not easily
available and I'm not digging down deep into the medical stuff I'm afraid. Anyway I found a method
which is called the Eppley maneuver. But before this maneuver can be used at least effectively,
you need to know where the otoliths are. So it's probably only likely to be one ear for example
and getting some idea which of the semi-circular canals as effective is also quite useful.
Well I worked this out by guesswork largely. This is why I wouldn't recommend you doing this yourself
if you experienced this thing. In fact the direction of the nystagmus indicates which ear is affected
but doing your own nystagmus diagnosis is not easy. I sort of guessed I thought that it was in
I forget which ear right here and so I worked on that principle. The severity of the BPPVR
had was fairly mild. I just had the dizziness and I managed to after having been caught unawares
by it in the first instance I was able to deal with it pretty well. Some people do actually they
just sort of live with it and it will sometimes correct itself because you've got this thing moving
around inside the canals of the ear. Sometimes they'll fall out of their own cord. Anyway I found
the aptly manoeuvre and gave it a try and found that it actually worked for me. I just tried it
once and it worked and I haven't had the problem since. Now I pointed at some details of all of this
stuff. If you go and look on Wikipedia you can find a complex comprehensive description of BPPV
and if you want to dig deeper into the structure of the inner ear I've put some article pointers
particularly to the vestibule and the semicircular canals. It looks like just about every other word
in these things is linked to something else where you can drill right down into the minute detail
if you really want to. I have done so but I'm not not going to share that with you because I'm
sure you won't want to know. I also put some stuff in about the aptly manoeuvre which there's
Wikipedia article about it and about Dr. Eppley himself and his discovery of this creation
invention of this manoeuvre. I find the YouTube animation that I've pointed to I think actually
explains things really well. Not quite as much detail as I've done here but hopefully you know
if you have this issue or you know somebody who has you might find that a useful thing to check out
but that was the process I actually used. There are there are others as I say it's the one I used
and that was the thing that seemed to give me relief. So in ending I'll just say that I guess
that I managed to hack my own inner ear but it was more by luck than anything else. Okay that's it
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