Auditory neuropathy spectrum disorder affects how sound signals travel from the inner ear to the brain, so hearing can seem inconsistent, especially in noise.
Specialist Vestibular Physiotherapy in Elstree, Borehamwood
Most people arrive here after months of being told their tests were normal. Harley AVM is a consultant-led clinic for hearing, tinnitus, dizziness and balance disorders, and at Elstree we treat exactly those cases: vertigo and BPPV, unsteadiness after an inner-ear infection, dizziness following a head injury, and the loss of confidence that comes with it. We also offer psychological support for tinnitus and PPPD.
About Harley AVM
Consultant-Led Balance Care, Now in Borehamwood
Harley AVM is a consultant-led practice specialising in hearing, tinnitus, dizziness and balance disorders. At our Elstree clinic we provide vestibular physiotherapy for vertigo, BPPV, unsteadiness, and dizziness that persists after a head injury or an inner-ear infection, alongside psychological support for tinnitus and PPPD. It is a therapy clinic, so the work here is a programme you build on over weeks rather than a single appointment.
What we do not do here is test. Hearing and balance diagnostics and consultant appointments happen at our Harley Street clinic, and anything that needs a diagnosis first goes there before therapy begins. Both sites share one clinical record, so you tell your story once. What makes us different is partly what we are not: not a general physiotherapy clinic, and not a hearing aid retailer. Balance is the whole of what we do, and nothing we recommend earns us a margin.
our services
What We Treat at Our Elstree Clinic
Auditory processing disorder affects how the brain interprets sound, even when hearing tests appear normal. It is common in both children and adults and often manageable with the right support.
Autoimmune inner ear disease can cause fluctuating hearing loss, tinnitus, or imbalance as the immune system affects inner ear structures. For many people, symptoms respond well to early treatment.
Feeling dizzy with sudden spins when turning in bed or looking up? You’re not alone; this common inner ear issue affects millions and is rarely serious.
Hearing a constant sound in both ears can feel unsettling, but bilateral tinnitus is common and often linked to hearing changes, stress, or sound exposure rather than serious disease.
Chronic unsteadiness or oscillopsia in dim light? Bilateral vestibular failure is a recognised condition often linked to ageing or medications, manageable for most, not typically ominous.
Sudden hearing loss, dizziness, or tinnitus with fatigue? Blood disorder symptoms affecting the inner ear are common and usually treatable, and they are not typically a sign of something serious. At Harley AVM, we address them effectively.
Many people experience listening difficulties even when hearing tests appear normal. Problems with sound processing, focus, or understanding speech in noise are common and often manageable.
Headaches, dizziness, or balance issues with neck pain? Chiari malformation symptoms are common and often manageable, not usually a sign of something acutely serious.
Conductive hearing loss is frequently caused by changes in the outer or middle ear, such as fluid build-up, infection, or blockage, and is often reversible.
Ear pain is a common experience and often comes from infections, pressure changes, or jaw and muscle strain rather than serious disease. Most episodes settle quickly with simple care.
Progressive hearing loss or balance issues in children or adults? An enlarged vestibular aqueduct is a common congenital inner ear anomaly that is long-term manageable and usually not a sign of acute danger.
Episodes of vertigo, ataxia, or imbalance lasting minutes to hours? Episodic ataxia type 2 is a manageable genetic condition affecting coordination, which is not typically dangerous.
Genetic hearing loss often runs in families and may appear at birth or later in life, progressing slowly over time. Many people live full, active lives with care.
Glue ear commonly affects children and adults when fluid collects behind the eardrum, causing muffled hearing or pressure. It settles with time and treatment.
Facial rash with ear pain, hearing changes, or vertigo? Herpes zoster (Ramsay Hunt Syndrome) reactivation is common, especially post-50, and usually treatable, not a serious long-term threat.
Hyperacusis makes everyday sounds feel uncomfortably loud or overwhelming, often without causing ear damage.
Hyperacusis makes everyday sounds feel uncomfortably loud or overwhelming, often without causing ear damage. Many people improve with the right guidance and care.
Itchy ears are very common and often relate to dry skin, mild irritation, allergies, or wax changes rather than serious disease. Symptoms usually settle with simple care.
Sudden vertigo with hearing changes after infection? Labyrinthitis is a common inner ear inflammation that improves for most and is not typically serious.
Dizziness, hearing changes, or tinnitus after starting medication? Ototoxicity side effects are common, usually reversible with prompt management, and are not typically a sign of a serious condition. At Harley AVM, we resolve them effectively.
Struggling with sudden vertigo, hearing fluctuations, or ear fullness? This inner ear disorder affects thousands and is manageable with proper care, not a sign of something dire.
Sudden clicking, fluttering, or tapping sounds in the ear can feel alarming, but middle ear myoclonus is often related to benign muscle spasms rather than serious disease.
Misophonia causes strong emotional and physical reactions to specific everyday sounds, such as chewing or breathing. Many people experience this sensitivity, and it does not indicate ear damage.
Dizziness, balance issues, or hearing changes? These vestibular symptoms are common in MS and often manageable, not usually a sign of something acutely serious.
Hearing a sound that others can hear too can feel unsettling, but objective tinnitus often relates to benign muscle or vascular activity near the ear.
Ototoxicity refers to hearing or balance changes linked to certain medications and treatments. Many effects are mild, temporary, or monitored safely during care.
Sudden dizziness or hearing shift after trauma or pressure changes? Perilymph fistula is a treatable inner ear fluid leak, not uncommon post-injury and rarely life-threatening.
Dizziness, vertigo, or balance problems after concussion? These symptoms are common and usually resolve with targeted rehab, not a sign of something serious.
Hearing changes after a head injury are common and may follow concussion, whiplash, or minor trauma. Symptoms often improve with time and support.
Persistent dizziness without spinning? PPPD is a common vestibular disorder triggered by prior events, manageable with targeted therapy, and not a sign of serious illness.
Hearing a rhythmic sound that matches your heartbeat can feel alarming, but pulsatile tinnitus is often linked to benign blood-flow changes or middle-ear factors rather than serious illness.
Sensorineural hearing loss is common and often develops gradually due to inner ear or auditory nerve changes linked to ageing, noise exposure, or illness, and it is usually not dangerous.
Unsteady gait, coordination issues, or dizziness? Spinocerebellar ataxia symptoms are common in genetic forms and progressive but manageable, not typically a sign of acute danger.
Rapid clicking or buzzing from the ear can be unsettling, but stapedial myoclonus commonly reflects brief muscle spasms rather than serious disease.
Sudden dizziness, hearing loss, or imbalance after a stroke? These vestibular symptoms are common in recovery and often improve with targeted rehab, not typically a sign of new serious issues.
Hearing your heartbeat or footsteps loudly? This thinning of the inner ear structure is uncommon but treatable, and it typically does not signal grave illness.
Tightening, fluttering, or rumbling sensations in the ear can feel distressing, but tensor tympani syndrome often reflects an overactive protective muscle rather than a serious disease.
Sudden dizziness, hearing loss, or imbalance? Transient ischaemic attacks (TIAs) are common, especially over 50, and often resolve quickly, not usually a lasting threat.
Hearing rapid clicking or tapping noises can be unsettling, but typewriter tinnitus is often linked to nerve irritation rather than serious disease.
Hearing a sound in one ear can feel worrying, but unilateral tinnitus is often linked to local ear changes, hearing variation, or temporary irritation rather than serious disease.
Dizzy spells with or without headaches? Vestibular migraine affects many and is highly manageable, not a harbinger of serious disease. At Harley AVM, our team delivers targeted control.
Sudden, severe vertigo after a viral illness? Vestibular neuritis is a common inner ear inflammation that resolves for most, not a sign of something grave.
Brief dizzy bursts or unsteadiness? Vestibular paroxysmia is a treatable nerve irritation disorder, not uncommon and rarely serious. At Harley AVM, our team provides effective control.
Unilateral hearing loss, tinnitus, or balance issues? Vestibular schwannoma (acoustic neuroma) symptoms are common and usually slow-growing, and are not typically a sign of something acutely serious.
OUR REVIEW
Trusted by Patients,
Proven by Results
EXCELLENT
Based on 114 reviews
Posted on Google![]()
clive drakeTrustindex verifies that the original source of the review is Google.
I have had my unbalance / vestibular medical problems for many years and almost given up on finding a knowledgeable Doctor and a clinic with the capabilities to help me understand the complex problem and work towards finding solutions. The Dr here and the facilities are exceptional, which I cannot praise enough. Very happy to found this place and cannot recommend high enough.Posted on Google![]()
Soydan OsmanTrustindex verifies that the original source of the review is Google.
I was seen by audiologist and Dr Arun, they were attentive, caring and took time to listen and adaptations were made throughout the appointment to support my anxiety and claustrophobia. This made a significant difference and genuinely helped me through the audiology testing. I gave an explanation of my current symptoms to Dr Arun he displayed great listening, compassion and understanding. The treatment I received on the day has greatly improved my symptoms, the one reassuring thing is any follow up is required is knowing that I will be in safe hands. I received my clinic letter promptly. After care queries handled by the admin team was exceptional, prompt and helpful. Overall the service was impeccable.Posted on Google![]()
Diana GranadosTrustindex verifies that the original source of the review is Google.
I had an outstanding experience with Harley Street Vestibular Clinic and cannot recommend them highly enough. I developed severe vertigo while visiting London, and it was an incredibly frightening experience as it was my first time ever experiencing dizziness like that. I called the clinic on a Saturday, fully expecting to leave a voicemail since they were closed. To my surprise, the office manager, Preeti, returned my call that same day. I was so grateful. She was kind, reassuring, and went above and beyond to arrange an appointment for me first thing on Monday. From the moment I arrived, the entire team was professional, efficient, and compassionate. They understood how urgent and distressing my symptoms were and made every effort to see me as quickly as possible. The vestibular audiologist was exceptional—she took the time to thoroughly evaluate me, clearly explain everything she was doing, answer every one of my questions, and perform the appropriate treatment. I never felt rushed, and her expertise immediately gave me confidence that I was in the right hands. The clinic was incredibly responsive, organized, and genuinely caring throughout the entire process. They turned what was a very scary situation into one where I felt supported and well cared for. I am truly thankful to Preeti and the entire team for their kindness, professionalism, and outstanding care. If you are experiencing vertigo, dizziness, or balance problems, I would not hesitate to recommend Harley Street Vestibular Clinic.Posted on Google![]()
erika thomaziTrustindex verifies that the original source of the review is Google.
Great positive experience!Posted on Google![]()
Carol BunyanTrustindex verifies that the original source of the review is Google.
I could not fault my follow up appointment with Dr Aran and his team. He really does take the time to listen to your questions and really puts himself out to set you on the road to recovery . He genuinely seems interested in getting you better. I would highly recommend this practice.Posted on Google![]()
Ged RobinsonTrustindex verifies that the original source of the review is Google.
Dr Benjamin Shaw was extremely thorough in his assessment of my recent attacks of vertigo. I have total confidence in his ability, once I have completed the further tests he has arranged at the Wimbledon clinic, to diagnose what is causing this issue with my health.Posted on Google![]()
Adrian LoweTrustindex verifies that the original source of the review is Google.
I thoroughly recommend the Harley Street Audio Vestibular Clinic. I had an appointment with Dr Rudy Palaniappan who listened carefully to me, conducted a brilliant examination and explained everything to me with a future plan very clearly. I was really impressed!Posted on Google![]()
EvanTrustindex verifies that the original source of the review is Google.
Dr Arun provided an excellent virtual consultation, took the time to understand symptoms and history and provided an initial diagnosis and treatment plan. It did not feel rushed or with any bias. Received comprehensive notes and summary promptly after the appointment. Would fully recommend.Posted on Google![]()
shahram zarafshanTrustindex verifies that the original source of the review is Google.
Dr. Arun Pajaniappane is a brilliant and expert doctor. He was also incredibly friendly, making for a truly excellent experience.
Accredited by Leading
Medical Association
OUR INDUSTRY ASSOCIATIONS
Aligned with Leading Medical Associations
At Harley Street Audiovestibular Clinic, we believe trust begins with accountability. That’s why we proudly hold accreditations and memberships with leading medical organisations that set the benchmark for clinical excellence. Our regulated status with the Care Quality Commission ensures every aspect of our service meets the highest standards of safety, quality, and transparency. These affiliations aren’t just formalities; they reflect our unwavering commitment to patient-centred care, continuous improvement, and evidence-based practice. When you choose us, you choose a clinic that is recognised, trusted, and dedicated to delivering the very best outcomes in audiovestibular health.
our team
The Team You Will
Meet in Elstree
Your appointments in Elstree are with our clinical therapy and rehabilitation team, working under the clinical governance of our Clinical Director. If your assessment shows you need a consultant, they will refer you in rather than continuing a course of therapy that was never going to be the right answer.
Major Insurance Providers Accepted
FAQS
Your Elstree Clinic Questions,
Answered
Got questions about our Borehamwood clinic? We have answered the most common ones below. If you have any further queries, our team is here and happy to help.
Where exactly is the Elstree clinic?
We are at Centennial Park, Centennial Avenue, Elstree, Borehamwood, Hertfordshire WD6 3FG. We see patients from across south Hertfordshire and north London, including Borehamwood, Radlett, Shenley, Bushey, Watford, Potters Bar, Barnet, Edgware, Mill Hill, St Albans, Harpenden, Chorleywood and Sarratt.
How quickly can I be seen?
We reply to enquiries within one working day and can usually offer an assessment in Elstree within two weeks. If your symptoms need urgent attention, we will tell you that rather than book you in.
Do I need a GP referral?
No. You can book directly. A referral letter is useful if you have one, particularly where there is a history of ear surgery or neurological symptoms, but it is not required.
Do you do hearing tests at Elstree?
No. All hearing and balance testing happens at our Harley Street clinic. If you need testing we arrange it, and your results come back to your therapist here.
Will I see a consultant at Elstree?
Not at this site. In Elstree you will see a vestibular physiotherapist or psychologist, working under our Clinical Director's governance. They can refer you to a consultant when you need one.
I have already had tests and they were all normal. Can you still help?
Yes, and this is one of the most common reasons people come to us. Normal scans and blood tests do not rule out a balance disorder. Several vestibular conditions are diagnosed on history and examination rather than on imaging.
What happens at my first appointment?
It lasts about an hour, and most of it is spent finding the cause. We take a detailed history, examine your eye movements, gaze stability, walking and balance, and test for BPPV where your history suggests it. We then explain what we found in plain English and give you a written home plan and a review date. Bring your medicines list, any previous results, your glasses and flat shoes.
What does psychological support at Elstree cover?
Dizziness and tinnitus wear people down. Poor sleep, avoiding places that set symptoms off, and worry about the next episode are part of the condition, not a separate weakness. Our psychology service is for balance and hearing conditions specifically, covering tinnitus management and PPPD. It is not a general anxiety or counselling service.
Vestibular and Balance Therapy in Borehamwood
Helping You Overcome Dizziness, Vertigo and Unsteadiness
You have probably waited long enough already. Tell us what is happening, and we will tell you where to start, including if that is not with us.


























































