The Relationship Between Hearing and Balance
How do ears effect balance?
The inner ear is made up of two parts: the cochlea, the organ of hearing; and the vestibular system, which is responsible for one portion of the balance system. This system is made up of a pair of complex fluid filled structures; three semicircular canals and two utricles in each ear. These organs work to keep people upright, stable and moving. The signals from the vestibular system and the cochlea are sent to the brain via neural signals, carrying information regarding our hearing and balance.
The proximity of these two structures, as well as the connection between the cochlea and vestibular nerve, means that hearing and balance disorders can often be related. This means that when there is a problem with one system, it can often affect the other system. Ear concerns can often impact our ability to maintain balance, walk, run, or stand. Additionally, people who have hearing loss and damage to their cochlea nerve, are more likely to have balance problems compared to people who do not have hearing loss.
There are several diseases that can affect both systems at the same time due to this direct link between the two systems. For example, there is a condition known as Labyrinthitis, which involves an infection of the inner ear. This condition causes symptoms such as hearing loss, tinnitus, nausea, and vertigo (a spinning sensation). Often this condition can be treated if the correct assessments are completed promptly after the sensations begin.
Also, there is a common vestibular condition called Meniere’s disease. This disease also causes attacks of vertigo, hearing loss, tinnitus, as well as a sensation of fullness in the ears. It is often caused by an increase in pressure in an area of the inner ear. While there is currently no known cure for Meniere’s disease, it is diagnosed through hearing tests and balance tests so that appropriate management can be advised to reduce the severity and occurrence of symptoms.
This link between the hearing and balance system means that it is essential an audiologist performs balance testing so that the ears and hearing are assessed at the same time. Through audiological and vestibular testing, an audiologist can determine the cause of dizziness and vertigo, whilst also managing the hearing loss if one is present. Vestibular disorders are evaluated with audiologic assessments, videonystagmography (VNG) and electrophysiological testing. This testing involves looking at how the balance organ works with the eyes, ears, joints, muscles, and skin. It is important that the cause of balance problems is known so that a solution and treatment can be found quickly.
There are many causes of imbalance and dizziness. These balance issues may or may not be associated with a hearing loss. However, it is important that vestibular and audiological tests are performed to assess if the balance and hearing organs are affected. This allows the audiologist to identify if your patient is experiencing a vestibular disorder, so that they receive appropriate treatment and management.