What Is Balance Disorder? The Connection Between Hearing and Balance

Did you know that ears are not just for hearing? They are connected to other aspects of your health including balance. Many dizzy spells and sensations of floating, spinning and faintness can all be traced to the inner ear.

Ears play a major role in keeping you upright on your feet. It’s important to pay attention to any ear problems that could potentially affect your balance.

How Do the Ears Affect Balance?

Balance is determined by a combination of our vision, the nerves in muscles and joints and the inner ear. These relay signals to the brainstem, allowing us to maintain our balance. While people with vision and nerve problems can easily compensate to maintain their balance, problems in the inner ear are much harder to compensate for. They often result in dizzy spells and balance disorders like vertigo.

The Anatomy of the Ear and Balance

The inner ear is made up of the cochlea, responsible for hearing functions, and the vestibular system, which controls balance. The vestibular system is composed of a network of looped tubes — three in each ear — known as the semicircular canals. These loop around the vestibule at the centre.

The vestibular system detects movement through sensory cells in the ear. These cells are activated every time you tilt or move your head. The system then sends signals to the vestibular nerve, combined with the cochlear nerve, all the way to the brain.

These sensory cells are small but mighty — they are very sensitive to even the smallest movements. It’s no surprise, then, that sudden, large, fast and prolonged movements — such as spinning around — can send these cells into overdrive. As a result, it can take you to take a while to regain your balance. This also causes the sensation of the room continuing to spin around you even when you’re no longer moving.

Balance Disorders: How They Start, and What the Ears Have to Do With Them

Balance disorders, such as vertigo, often present as lightheadedness or faintness, accompanied by rotational sensations. Many describe it as the world around you is spinning. These indicate problems in the vestibular system, particularly the sensory cells that detect even the slightest of movements.

Problems in the inner ear can affect how these cells detect movement and provide the input required to keep you standing upright. While it’s common to sometimes trip on your own feet or lose your balance momentarily, prolonged inner ear problems or an inner ear disorder can cause balance disorders. You can have difficulty perceiving movement and feel lightheaded, faint, unsteady and disoriented.

Types of Balance Disorders

While balance disorders are related to hearing in the inner ear, they present and affect people differently, resulting in different types. The most commonly observed hearing balance disorders include:

• Benign paroxysmal positional vertigo indicates a mechanical problem in the inner ear. It’s caused by dislodged calcium carbonate migrating into the fluid-filled semicircular canals. Calcium carbonate crystals interfere with normal fluid movement that these canals use to detect head motion. This in turn causes the inner ear to send false signals to the brain. As a result, you experience brief but severe spinning sensations with movement.
• Meniere’s disease causes vertigo attacks, hearing loss, tinnitus, and a sensation of fullness in the ears. Meniere’s is caused by increased pressure from an abnormally large amount of endolymph in the inner ear or potassium in the inner ear vicinity.
• Vestibular neuronitis is a balance disorder caused by a viral infection that inflames the inner ear and the nerves connecting it to the brain. Inflammation disrupts the normal transmission of sensory signals to the brain, resulting in vertigo and balance issues.
• Migraine-associated vertigo occurs in about 40% of people who experience migraines. This causes balance issues or dizzy spells during, after or even completely independent of the migraine itself.
• Age-related dizziness and imbalance is attributed to weaker muscles, decreased visual acuity and aging vestibular systems that affect the inner ear and hearing.

Diagnosing Balance Disorders

We’re all human. There really are times when we simply trip on our own feet. We fall or feel dizzy and disoriented due to any number of factors. However, if these events recur, it’s always best to consult your doctor and diagnose any inner ear or hearing problem. You may have a diagnosable balance disorder.

Balance disorders are typically diagnosed through a Videonystagmography (VNG), along with an audiology test and MRI scan. A VNG examines a particular type of eye movement called nystagmus, which occurs due to the brain trying to determine the position of the body as it receives conflicting signals from the ears. The presence of nystagmus indicates the position in which you feel dizzy. However, it is always related to the position you are in, and not all dizzy spells are caused by it.

Here’s how a VNG is done:

1. Ocular mobility: you will be asked to watch steady and moving dots projected on a wall.
2. Rotational chair: your chair will be rotated slowly to stimulate the sensory cells in the inner ear, allowing your hearing healthcare provider to observe how this affects your balance in a safe and controlled environment.
3. Positional nystagmus: your head and body will be moved into different positions to assess the presence of nystagmus.
4. Caloric testing: your hearing healthcare provider will introduce air or water in the ear canal at different temperatures to stimulate the inner ear to determine if one ear reacts differently, indicating a weakness in the inner ear.

Will a Balance Disorder Cause Hearing Loss?

When you hear about ear problems, it’s common to first think about hearing loss. Knowing that the inner ear plays a key role in maintaining balance, many patients worry that experiencing a balance disorder will result in hearing loss.

Generally, hearing loss is either age-related or noise-induced, with a smaller percentage of cases attributed to illness, infection and trauma. Meanwhile, balance disorders occur because of specific issues in the inner ear.

However, depending on the underlying cause and specific damage to the inner ear, hearing loss and balance disorders could be related or occur separately. The best thing to do is consult your hearing healthcare provider regarding symptoms related to both so that they can diagnose and treat accordingly.

To learn more about hearing and balance disorders, call Living Sounds at 855-628-5153 or contact us here.