How Hearing Loss Can Affect Your Balance

There is an important link between your overall hearing health and how well your body can maintain balance.

In fact, instability and other balance issues could result from issues with your ears and your auditory system. 

In that sense, issues with your ears can affect more than just your hearing.

Issues with hearing loss can run parallel with difficulties walking, running, sitting, and more. 

Aside from bringing down your quality of life, balance problems can also put you at greater risk of falls, leading to serious head injury. 

The auditory and balance systems work in concert with one another. Here, we take some time to explore their relationship in greater detail, helping you understand how hearing loss can affect your sense of balance. 

What Is Hearing Loss?

In short, hearing loss can have many causes.

However, regardless of the cause, hearing happens when the auditory system isn’t working properly. 

By 2050 the World Health Organization projects that roughly 2.5 billion people will be living with disabling hearing loss.

The National Institute on Deafness and Other Communication Disorders states that age is among the strongest predictors of hearing loss, especially among those between the ages of 20 to 69.

Age-related hearing loss belongs to a type of hearing loss known as sensorineural hearing loss.

Sensorineural Hearing Loss

While sudden sensorineural hearing loss is possible, it is typically a gradual process that happens slowly over time.

Essentially, structures in the inner ear, like hair cells or the auditory nerves, slowly degenerate with age causing hearing loss. 

But aging isn’t the only cause of sensorineural hearing loss; other less common causes include conditions like Ménière’s disease, cochlear otosclerosis, certain types of autoimmune inner ear disease, and tumors.

Common treatments for sensorineural hearing loss include hearing aids and cochlear implants.

Some Risks Factors for Hearing Loss

While there can be numerous causes for hearing loss, several common risk factors are important to understand. Some common risk factors include medication side effects, illness and infection, and exposure to loud noise.

What Is the Link Between Hearing Loss and Balance?

The same structures that house and control our hearing ability also control equilibrium or balance.

Issues in these systems can cause not only loss of hearing but also balance disorders. Let’s take a closer look.

The Auditory and Vestibular System

Hearing loss happens when the auditory system is out of whack.

This imbalance can come from injury, illness, or aging. Issues in these systems can affect both hearing and balance.

The three main players of the auditory system are the outer, middle, and inner ear.

They each work together to help convert and send sound waves to the brain to be processed. Let’s take a closer look at the anatomy of the auditory system.

  • The Outer Ear. The visible part of the ear is known as the outer ear. Its primary job is to gather sound waves and divert them into the ear canals. The outer ear comprises two parts: the pinna and the ear canal (ending at the eardrum). The pinna is the cup-shaped part of the ear that is visible.
  • The Middle Ear. The middle ear is home to the eardrum and the ossicles. The ossicles are a set of small bones (malleus, incus, and stapes) that help send vibration to the inner ear. Sound enters the ear causing the eardrum and ossicles to move. These vibrations get sent as signals to the brain.
  • The Inner Ear. The inner ear houses the cochlea, a small snail-shaped organ, and a network of semicircular canals, hair cells, and nerves. The inner ear converts vibrations into electrical signals and transmits them to the brain through the auditory nerve. The relationship between hearing loss and balance is most prominent in the inner ear. 

How Does the Inner Ear Affect Balance?

Aside from housing some of the most important components for hearing, the inner ear is home to the main parts of the vestibular system.

The vestibular system provides the body with a sense of balance. It provides the brain with information about motion and head and body position in relation to the surroundings. 

The main components of the vestibular system are in the inner ear.

This interconnected main system of compartments is the vestibular labyrinth. The vestibular labyrinth is composed of:

  • Semicircular canals
  • Vestibular receptors
  • Vestibulocochlear nerve
  • Vestibular hair cells
  • Otolith organs (utricle and sacculus)

In short, the vestibular system is crucial for normal movement and equilibrium.

When this system is compromised, balance disorders can occur. 

What Is the Link Between Balance Disorders and Hearing Loss?

A balance disorder is a condition that makes you feel dizzy or unsteady.

The sensation of moving, spinning, or floating while standing, sitting, or lying down is common with balance disorders. 

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), balance problems or issues with dizziness affects roughly 15 percent of American adults. 

Aside from dizziness, symptoms of balances disorders can also include:

  • Vertigo (spinning sensation)
  • Lightheadedness
  • Disorientation
  • Faintness
  • Blurred vision 
  • Nausea and motion sickness
  • Headaches
  • Low blood pressure

One example of a balance disorder is benign paroxysmal positional vertigo (BPPV).

Essentially, BPPV disrupts sensory systems and includes an intense episode of vertigo triggered by positional head movement. 

Vestibular neuronitis is another balance disorder that leads to vertigo.

This vestibular disorder is caused by inflammation and infection of the inner ear, specifically the vestibular nerve.

Does Hearing Loss Cause Balance Problems?

Since the same system regulates your hearing and balance, it's no surprise that the two are intertwined — when one is out of whack, the other is as well.

However, two conditions bring closer the connection between hearing loss and balance. 

Labyrinthitis

Labyrinthitis refers to an infection of the inner.

This infection leads to inflammation of the labyrinth, an important component of the balance center (vestibular system). 

This condition can lead to temporary hearing loss due to inflammation, fluid buildup, vertigo, tinnitus, and balance issues. 

Ménière's Disease

The exact causes of Ménière's disease are unknown, but many researchers believe it has something to do with fluid volume change in the labyrinth. 

Ménière's disease often includes episodes of hearing loss, balance issues like vertigo, and tinnitus. Typically, this condition affects only one side. 

Diagnosing and Testing for Hearing Loss and Balance

If you're experiencing hearing loss and associated balance issues, the best thing to do is to seek advice from a healthcare provider in the audiology field, like an audiologist or ENT.

They can perform hearing tests to determine if any hearing impairments are present. Audiologists can also perform balance tests. Two tests that seek to address issues with hearing and balance include:

  • Videonystagmography (VNG) test: This helps detect involuntary eye movements, which can contribute to disorders of the inner ear. 
  • Auditory brainstem evoked response (ABR): This test seeks to uncover issues with the nerves that connect the hearing and balance systems to the brain. 

Conclusion

Hearing and balance share a close relationship since they use some body systems.

The auditory and vestibular systems share the same anatomy and work together to keep you hearing well and keep you steady on your feet. 

However, because of this relationship, conditions that contribute to hearing loss can also contribute to a loss of balance. 

If issues of hearing loss and balance occur, make sure you reach out to your healthcare provider, who can offer medical advice on potential causes and treatment options. 

Looking for more information on hearing loss? Explore the rest of the USA Rx blog here.

References, Studies and Sources:

Deafness and hearing loss | WHO

Quick Statistics About Hearing | NIDCD

The Vestibular System – Neuroscience | NCBI Bookshelf

Balance Disorders — Causes, Types & Treatment | NIDC