The Role of Ears in the Balance System

The Role of Ears in the Balance System

Did you know that the system for balance and our ability to maintain it is in the ears? Known as the vestibular system, this sensory system, and network are responsible for providing the brain with information regarding position, spatial orientation, and movement. Various factors can affect this system and contribute to balance disorders. There are ways that balance issues are effectively addressed and managed. Learning about the role of the ears in the balance system is a useful way to understand any symptoms you may be experiencing. 

What is the Balance System?

The vestibular system is a sensory system that sends the brain information about spatial orientation, head position, and motion. It also maintains motor functions that enable us to keep our balance, maintain posture, as well as stabilize our head during movements.  The main part of the vestibular system is what’s called the vestibular labyrinth. This consists of a network of semicircular canals, otolith organs, and the vestibulocochlear nerve.  The semicircular canals are made of three loops or tubes that each detect a specific motion: 

  • First canal: nodding up and down motions
  • Second canal: side-to-side movements
  • Third canal: tilting left and right movements 

These semicircular canals are filled with fluid known as endolymph and hair cells which are the sensory receptors of the vestibular system. These sensory cells send vestibular information about movement and stability to the brain through the vestibulocochlear nerve. This includes information about the position, head movement, and motion. The brain also uses signals received from visual and muscle information to understand spatial orientation. There are ways that this system and processes can be disrupted which leads to balance disorders. 

Balance Disorders

According to the National Institute on Deafness & Other Communication Disorders, 15% of adults in the U.S. (33 million people) have issues with balance and/or dizziness. Additionally, rates of balance disorders increase with age. It is estimated that: 

  • 20% of adults ages 65-75 have a balance disorder. 
  • 25% of adults ages 75 and older have a balance disorder. 

A balance disorder is a medical condition that is characterized by a reduced capacity to maintain balance and/or also the experience of vertigo. Vertigo is the sensation that the environment around you is spinning, producing dizzy spells that can be intermittent or chronic. Common causes of a balance disorder include: 

  • Inner ear disorders: Meniere’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuronitis, labyrinthitis
  • Head or neck injuries 
  • Hearing loss
  • Viral or bacterial infections 
  • Blood circulation issues like high or low blood pressure 
  • Medical conditions like Alzheimer’s and multiple sclerosis 

Balance disorders can produce the following symptoms: 

  • Bouts of dizziness and vertigo
  • Falls or the sense that you are going to fall
  • Blurred vision
  • Feeling faint or lightheaded
  • Headaches 
  • Motion sickness, nausea
  • Confusion or disorientation 

These symptoms can be in and out or more chronic which can take a toll on daily life. 

Treating Balance Disorders

To diagnose balance disorders, you will likely be referred to a specialist that works with ear-related conditions. This includes an ENT (ear, nose, throat) doctor which is also referred to as an otolaryngologist. They may perform a few different evaluations including a hearing test, blood work, and imaging tests. Depending on the underlying condition producing the balance disorder, treatment can include the following: 

  • Medications: antibiotics can be prescribed to treat bacterial infections contributing to balance issues. Additionally, other medications can be prescribed to alleviate symptoms like dizziness and nausea (typical of inner ear disorders like Meniere’s disease). These medications include lorazepam, diazepam, meclizine, and glycopyrrolate. 
  • Vestibular Rehabilitation Therapy (VRT): this type of therapy involves performing exercises that include the body, eyes, and head movements without triggering dizziness or vertigo.
  • Canalith repositioning: this treatment option is used to treat BPPV (an inner ear disorder) which is caused when calcium crystals in the otolith organs become dislodged. It involves performing head exercises that are designed to reposition these crystals. 

Our practice provides invisibilized care and comprehensive services including diagnosing and treating balance disorders. If you have experienced any of the symptoms described, please contact us to learn more. We look forward to scheduling an appointment so that you can access the treatment you need!