Hearing and Balance: Do Hearing Aids Help?

The inner ear organs for hearing and balance are physically connected. The cochlea, the small snail shaped organ in the inner ear, is the sensory organ for hearing. The tiny hair cells in the cochlea are stimulated by the vibration of the middle ear bones and that stimulation is transmitted along the auditory nerve to the brain where it is perceived as sound.

The semicircular canals are three tiny loops inside the skull that contain fluid and balance receptors. These inner ear organs work as a pair. Movement of the fluid in the semicircular canals moves the otoliths, microscopic calcium carbonate crystals, and that movement is perceived by the brain as forward, backward, up, down, and side to side motion. Since the cochlea and the semicircular canals share fluid and nerve endings, disorders that affect hearing can also affect balance.

There are two common symptoms of balance dysfunction. Vertigo is a sensation of turning or rotating. Generally, this symptom indicates a problem with the inner ear. Dizziness is a sensation of light headedness or feeling faint. While dizziness can be associated with an ear dysfunction, it is more likely to be caused by vascular, heart, or medication issues, such ototoxicity. Neither vertigo nor dizziness is a disease, but instead they are symptoms of a health issue that requires medical attention. 

Since vertigo and dizziness can be debilitating, people are eager to seek treatment options. However, it is of critical importance to first have a complete balance evaluation to determine the cause of these symptoms. To fully assess dizziness an evaluation should include an examination of the eyes, ears, and overall health. The eyes, ears, and musculoskeletal system work together to create stable balance function. A common analogy is that balance is like a three-legged stool – vision, ear function, and motor muscle coordination keep us upright.  If there is a problem with any of the “legs” of the stool – there will be imbalance which is perceived as vertigo or dizziness. A balance evaluation should include an eye exam, hearing assessment, and specialized testing to evaluate the entire balance system.

Hearing loss has an enormous impact on balance. Recent research at Johns Hopkins has shown that people with even a mild hearing loss are three times more likely to fall. Every additional 10-decibels of hearing loss increased the chances of falling by 1.4-fold.¹ Even accounting for other health factors, hearing loss is the leading indicator of fall risk: It is believed that hearing loss reduces the perception of environmental cues and increases cognitive loading that can lead to falls. 

There are some balance disorders, such as Meniere’s disease, which cause fluctuating hearing loss and vertigo. Digital hearing aids which can accommodate these changes in hearing are especially helpful for people managing this condition. Because hearing loss has a direct effect on balance, hearing aids, when appropriate, can also provide improved function for anyone with hearing loss and imbalance. While hearing aids will not cure vertigo or dizziness, they can be a critical component of the treatment process. When used as part of the overall treatment program for balance dysfunction, hearing aids can accelerate the treatment process and help maintain better function and stability when the vertigo is resolved.    

Hearing aids should not cause vertigo. However, there are some medical conditions, for example perilymph fistula or semicircular canal dehiscence, that can cause vertigo or dizziness in response to amplified sounds. If you notice dizziness with hearing aid use, you should schedule an appointment with your physician to have your ears and hearing evaluated.

Dizziness or vertigo can be a serious symptom of an inner ear dysfunction. A thorough evaluation of imbalance is necessary to avoid falls and serious injury. Hearing, vision, and physical health are all related to balance. Appropriately fitted hearing aids can be a factor in improving not only hearing, but balance control, stability, and overall health.