Hearing Loss and the Vestibular System
August 4, 2021
Hearing loss, in some cases, may not only affect your hearing but can also result in balance issues. Your ears don’t only help you hear, they are also responsible for your body’s sense of balance. In the inner ear, we have a structure called the labyrinth. The labyrinth houses the cochlea (the hearing organ), three semicircular canals (superior, posterior, and horizontal canals), and otolith organs (utricle and saccule). Otolith is Greek for “ear stones”.
The three semicircular canals and otolith organs in our inner ear are responsible for our balance and are also collectively known as the vestibular system. The vestibular system is responsible for maintaining balance, posture, and the body’s orientation in space. It also detects head movements in three dimensions, provides the perception of movement, and stabilizes images on the retina during head movements. The vestibular system works closely with your visual system to alert the body of its position relative to earth and gravity, and this allows you to coordinate your movements accurately.
A vestibular disorder may occur if you have a disease that affects this system or if you have any damage to your vestibular system. Factors such as certain medications, ear infections, head injury, poor blood circulation in the inner ear, and low blood pressure may cause vestibular disorders. Vestibular disorders may present with many symptoms such as:
- hearing loss
- falling or staggering when trying to walk
- light-headedness, fainting, or floating sensation
- blurred vision
- confusion or disorientation.
Additional symptoms may be nausea and vomiting. Depending on the vestibular disorder, these symptoms may last from a few seconds to a few weeks or weeks.
Hearing loss can occur independently or can co-occur with a vestibular disorder. Hearing loss itself is not a cause for a vestibular disorder however, damage within the inner ear responsible for the hearing system may contribute to a vestibular disorder. This means that hearing loss may be a sign of an underlying condition which impairs your balance.
A few diseases may result in both hearing and vestibular problems. A common disease that causes hearing loss and vestibular problems is Meniere’s disease. Meniere’s disease is the increased pressure in the inner ear organs and one can usually feel this pressure build-up before an episode of this condition occurs. These episodes include multiple, and intermediate attacks of vertigo. The vertigo episodes typically occur with tinnitus (ringing in the ears) and can cause a low-frequency sensorineural hearing loss over time. Unfortunately, there is no cure for this disease although medication can reduce the intensity of the symptoms.
Superior semi-circular canal dehiscence syndrome (SSCD) is another disease where both balance and hearing problems occur. SSCD is a rare medical condition where the temporal bone overlying the superior semi-circular canal of the inner ear is abnormally thin or absent. This syndrome results in sound or pressure-induced vertigo and chronic unsteadiness. It can result in hearing problems by causing low-frequency conductive hearing loss and tinnitus.
Two other conditions can also lead to balance and hearing problems. A vestibular schwannoma is a slow-growing tumor (usually a benign tumor), that develops on the balance and hearing nerves and is yet another condition that affects both hearing and balance. The symptoms of a vestibular schwannoma are vertigo and disequilibrium. It can also result in unilateral hearing loss with tinnitus.
Labyrinthitis is an infection of the inner ear where the structures within the inner ear become swollen and inflamed. This disease can cause a hearing loss accompanied by tinnitus as well as feelings of nausea and vertigo.
Examples of hearing losses that present with no balance issues are noise-induced hearing loss (NIHL) and presbycusis. NIHL is a loss caused by damage to the hair cells in the cochlea due to exposure to noise. NIHL is solely hearing loss with no balance issues. Individuals with a case of NIHL will often complain of having difficulty hearing speech in the presence of background noise. Presbycusis is an age-related hearing loss that occurs gradually over time and causes a high-frequency hearing loss. Presbycusis is one of the most common conditions affecting the elderly community.
A balance disorder can occur without the presence of hearing loss. An example of this is Benign Paroxysmal Positional Vertigo (BPPV). BPPV causes a sudden and brief spell of vertigo triggered by head movements. BPPV occurs when gel-filled crystals in the vestibular system loosen and float into one of the semi-circular canals. Eventually, a lot of these crystals end up in the semi-circular canal, and the fluid in this canal doesn’t flow as it should. This results in incorrect balance signals getting sent to your brain, resulting in vertigo.
As noted above, multiple factors can lead to hearing loss and a balance disorder. It can have a significant impact on your quality of life and can cause a social and economic burden on yourself, family members, and friends. Hearing healthcare professionals don’t just treat hearing loss, they also help and provide solutions with balance disorders. Therefore, if you or your loved ones are suffering from a hearing or balance disorder, call your nearest hearing healthcare professional for help.
Curious about your hearing health?
Lexie Hearing offers a free online hearing test that you can take from the comfort of your home. The test results will indicate if you can benefit from wearing hearing aids, and if you can, you can speak with one of our hearing experts for more information. It’s never been easier to look after your hearing health.