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What Do Your Ears Have To Do with Balance?

The ears are one part of a complicated system that helps our bodies keep balance. Doctor Gans tells us all about the individual parts and how they work together.


What do your ears have to do with balance? That’s our topic today on Ask the Hearing Doctors.


Hi, I’m Dr. Ashley Wilcox, audiologist at Hearing Doctors. The Washington metropolitan areas highest rated audiology practice with over 1500, 5-star reviews. Today, we’re here with Dr. Gans, founder of American Institute of Balance. It’s a pleasure to have you here.


Thank you, Dr. Wilcox. Happy to be here.


Perfect. So today we’re going to be talking about balance. So, I have a couple of questions for you. A lot of people actually don’t realize that the ears have anything to do with balance. So, could you tell me a little bit about what our ears have to do with balance and keeping us, you know, not feeling dizzy?


Dr. Wilcox, that is a great question. I’m going to use a very, very big word called phylogeny. Phylogeny is how we develop as an embryo. And believe it or not, the balance portion of our inner ear develops by 49 days in utero. In other words, it’s not the cochlea, the hearing part of the ear that develops first, it is the balance part of the ear. So, the inner ear is very, very much focused on balance and equilibrium. And there are different parts of the inner ear that affect balance. And we’ll talk about some of those as we go further into our conversation today.


So, you said the system develops early. Could you tell us a little bit more about that system, what it’s called?


Well, this is called the vestibular system or sometimes the labyrinth. So, if you’ve ever seen a snail that’s really kind of what it looks like. And interestingly, it’s actually filled with two types of fluid that have the same weight and thickness or viscosity as seawater. And the gravity detector is actually filled with calcium carbonate. So, this snail if you will, has a downstairs and an upstairs.


The downstairs is called the otolith system. And this sand filled system as we move, tells us about the pull of gravity. The upstairs looks like a pretzel with three rings. These are called the semicircular canals. So, the downstairs tells us about the pull of gravity and the rings or circles. Tell us about the speed and direction that her head is moving in.


So, it takes both of these gravity and navigation for us to be able to keep our balance.


That’s fascinating. So, what other systems of the body help us with balance?


Well, that’s another great question, because the ear can’t do everything but the inner ear. The balance part of her inner ear does contribute two thirds of everything the brain needs to make decisions about the pull of gravity and what’s going on in the world around us. So, we can think of this almost like a tripod. Who are the two other players then?


Well, contributing to the other third is vision and our sense of touch. That’s why it’s so important if you wear glasses to make sure you have recent eye exams. So, if you need refraction, you’re wearing the right prescription. Likewise, Ophthalmologic conditions like glaucoma, diabetic retinopathy, macular degeneration can also affect our balance. If people have neuropathy of their feet, lower extremities due to diabetes, they also if they can’t feel the ground, it can be quite challenging.


And that’s why it’s so important for anybody who has visual challenges, touch like neuropathy, challenges that they’re sure that they get comprehensive neurodiagnostic testing because just like a three-legged stool, if any one of those legs is challenged or becomes wiggly, Timber! Gravity always works, gravity always wins.


So, let’s say what happens if the vestibular or balance system isn’t working? What do you suspect then?


Well, that’s a good point. So, remember we talked about the downstairs and the upstairs. It’s critically important that we understand which ones are working or not working. Give you an example. If the lights in your house, you have a two-story house and the lights are working upstairs, but not downstairs. Where is the problem? Is it in the fuse box? Is it the feed from the street? Right. So, we need to know that.


So that’s why we need to look at a comprehensive view. And that’s why we need these different type of evaluations. Which there’s no pins or needles or blood draws. We we can even do these tests on infants. That’s how easy they are. And we can find out is it the gravity sensor that’s giving us trouble and or is it the velocity, these upper rings?


And if it is the upper rings, is it one ring, two ring or three rings? Right. So, all of this knowledge we are going to use to decide how to make you better and keep you from falling.


That’s awesome. Thank you so much. For this information.


My pleasure, Dr. Wilcox.


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Dr. Ana Anzola, CCC-A, FAAA, ABA Principal

Dr. Anzola received her Doctorate degree in Audiology (AuD) from the Arizona School of Health Sciences, and her Master’s Degree in Audiology and her Bachelor's Degree in Speech Language Pathology and Audiology from Towson University. She has been a fellow of the American Academy of Audiology (AAA) since 1995, board-certified by the American Board of Audiology (ABA), and certified by the American Speech-Language-Hearing Association (ASHA).


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