Hearing Loss and Balance

When you lose your hearing, it’s difficult to keep track of what’s happening in the world around you. Of course, that’s because your ears play a vital role in helping you hear voices and other sounds. But that’s not all — your ears also help you maintain a sense of balance and control over your body when you are sitting, standing or walking.

Many medical issues can impact your hearing and your balance, including:

• Ear infections.
• Fluid in the ears.
• Tinnitus (ringing in the ears).
• Dizziness and vertigo (the feeling you are moving when you are not).
• Tumors of the ears.
• Meniere’s disease (attacks of dizziness, hearing loss and ringing in the ear).

To find out what’s causing your hearing loss or balance issues, our ENT doctors look at your health history and perform an examination. They may check for allergies. And they may also use highly specialized assessment tests to check your eye movements, body movements and reaction to sounds. After determining the cause of your hearing or balance issues, your doctor will determine the best treatment options.

Treatment for Medical Issues That Affect Your Hearing and Balance

Ear Infections

After you’ve had a sore throat, cold or other upper respiratory illness, the infection may spread to the middle ear and cause inflammation and fluid buildup behind the eardrum. This condition is an ear infection — also called acute otitis media.

With ear infections, you may experience:

• Pain.
• Feeling of fullness in the ear.
• Fluid drainage.
• Fever.
• Hearing loss.

To diagnose ear infections, doctors will use a lighted tool called an otoscope to see inside the ear and check for infected fluid. Your doctor may also do a tympanometry, a test that measures the movement of the eardrum and checks the function of the middle ear.

To treat ear infections, your doctor may recommend:

• Antibiotics (for severe ear infections or infections that last longer than a few days).
• Pain relievers (typically acetaminophen or ibuprofen, which also helps reduce fever).
• A warming pad to ease pain.
• Small tubes in the eardrum (for chronic ear infections).

Ear Fluid

When you have a buildup of liquid or mucus behind the eardrum — without pain, fever or other signs of an ear infection — you may have fluid in the ears, a condition called otitis media with effusion (fluid).

Ear fluid can affect people of any age, but it’s most common in young children. Doctors can detect fluid buildup by checking the ear canal with an otoscope or by testing movement of the eardrum. Otherwise, symptoms of ear fluid are subtle:

• Mild discomfort.
• Fullness in the ear.
• Muffled hearing or clumsiness.

Doctors don’t usually treat ear fluid, unless there is an infection. Usually ear fluid goes away on its own in a period of weeks or months. Long term fluid buildup can damage the ear, so it’s important to follow up with a doctor in a few months to be sure the fluid is gone. In children, a persistent buildup of fluid in the ears can make speech delays or learning issues worse.

To treat ear fluid that does not go away on its own, your doctor may recommend:

• A single trial of antibiotics (if not given earlier).
• Ear tubes to drain fluid, improve hearing, and reduce risk of infection.
• Surgery that helps the eustachian tube (inside the ear) drain the fluid properly.

Tinnitus

If you have tinnitus, you hear ringing in one or both ears. The sound may be constant or it may come and go. For some people, the noise sounds like buzzing, roaring, clicking or hissing.

Potential causes include:

• Damage to nerve endings in the inner ear.
• Stiffening of bones in the middle ear.
• High or low blood pressure.
• Wax buildup.
• Certain medicines.
• Tumor.
• Diabetes.
• Head or neck injury.

To diagnose tinnitus, doctors need to assess your health history and do a complete physical exam and possibly an audiological evaluation. Depending on your case, treatment may include:

• Hearing aids.
• Cochlear implants for hearing loss.
• Electronic devices to mask the sound or make the ringing seem softer.
• Surgery to remove a tumor.
• Therapy to help you cope with the ringing sound.

Dizziness and Vertigo

Dizziness is a term used to describe a range of sensations — such as feeling faint, woozy, disoriented, weak or unsteady. If you feel like the room is spinning or you are moving, you have vertigo.

It’s tricky to pinpoint any one cause. Sometimes it begins suddenly. Causes of dizziness and vertigo include:

• Ear infection.
• Head injury.
• Advancing age.
• Medications.
• Low blood pressure.
• Displaced calcium crystals in the inner ear (called benign paroxysmal positional vertigo).
• Other disorders stemming from vision, muscles, bones or joints.

To determine the best treatment method, doctors will do a careful evaluation to determine the cause of your dizziness and vertigo. Treatments may include:

• Medication (to reduce nausea and motion sickness).
• Antibiotics (to treat an ear infection).
• Anti-anxiety drugs.
• A special method in which the head and body are carefully moved in a certain position in order to reposition displaced calcium crystals in the inner ear (for benign paroxysmal positional vertigo).
• Vestibular rehabilitation therapy (exercises that help reduce dizziness symptoms and control your sense of balance).

Tumors

Sometimes a tumor, called an acoustic neuroma, grows in the inner ear. It affects the hearing and balance nerves, causing hearing loss, imbalance and ringing in the ear (tinnitus). It may also cause weakness or numbness in the facial nerves.

Treatment includes:

• Surgery to remove the tumor.
• Radiation therapy to reduce the size or limit the growth of the tumor.

Meniere’s Disease

Meniere’s disease is balance disorder caused by an abnormality in part of the inner ear called the labyrinth. If too much fluid builds up here, you may experience:

• A severe spinning sensation.
• Nausea and vomiting.
• Loss of hearing or muffled hearing.
• Loss of balance.
• Headaches.

Meniere’s disease may be caused by:

• Allergies.
• Abnormal immune response.
• Head injury.
• Migraine headaches.
• A viral infection.

Anyone call get Meniere’s disease, but it’s most common in people in their 40s and 50s. There is no cure. Treatments may include:

• Medicine (to reduce fluid buildup, dizziness, or improve circulation in the inner ear).
• Surgery to treat balance issues.
• Diet changes (Eliminating caffeine, chocolate, alcohol and salt may reduce symptoms.).

How to Reduce Your Risk of Hearing Loss and Balance Disorders

To reduce your risk of hearing loss and balance disorders, consider taking these precautions:

Vaccinations. Make sure you and your children are up-to-date on your vaccinations. Viruses often cause ear infections, which may lead to hearing loss. Studies show that people who have been vaccinated get far fewer ear infections than those who have not.

Wash hands. Frequent handwashing can help prevent the spread of germs that lead to colds, flu and ear infections.

Protect your ears. To prevent hearing loss, wear ear protection when swimming, attending concerts and working with noisy devices, lawn mowers and power tools. If you listen to audio devices through earbuds or headphones, listen at a safe level.