The Relationship Between Hearing and Balance Function: Toward a Unitary Study of the Auditory and Vestibular Systems

As an audiologist, the renewed interest in simultaneously studying the effects of factors such as age, noise exposure, and genetics on both the vestibular system and the auditory system is exciting. Historically, many of us in the profession doing research would identify as individuals who investigate vestibular and balance function or some line of auditory function. Accordingly, there are large bodies of literature for each system, but comparably very few that address the effects of similar disorders and testing on both systems in the same study subjects.

In my role as an editor, reviewer, and an individual who serves on grant-review panels, I am seeing more studies than ever before that are considering the effects of environmental factors or disorders on both systems. An example of this shift in research is a timely article titled “Similarities and Differences Between Vestibular and Cochlear Systems: A Review of Clinical and Physiological Evidence”.[1]

In this review, the investigators discuss how sound can be used to stimulate both hearing and balance organs. In this vein, there is now strong physiological evidence from animals that noise exposure can lead to otolith dysfunction.[2] In humans, Akin and colleagues[3] demonstrated that noise exposure can have effects on the cervical vestibular-evoked myogenic potential that is an electrophysiological measure of saccular function.

Studies such as these offer compelling evidence that, in a world where noise levels from urban areas and personal sound devices are far above anything that would be encountered in nature, noises are putting the vestibular system at risk. The inner ear of hearing and balance is simply not designed to handle these extremely loud sounds. Now that this is being acknowledged by the scientific community, the work regarding designing investigations examining the functional consequences of simultaneous hearing and balance impairment is emerging at a fast rate.

In this issue of the Journal of the American Academy of Audiology, Dr. Tamaki and her colleagues at Gallaudet University present an exciting study of participants who are deaf with and without vestibular impairments and their balance ability. The results are fascinating. This is another great example of a project focused on investigating the connections between the two sensory systems.

This weekend, I will be attending the University of Michigan football game. The stadium “Big House” seats approximately 108,000 fans. There is no question that I will bring my hearing protection, which will not only protect my hearing but also my vestibular function.

One interesting fact about college football and Gallaudet is that the football huddle was first organized by quarterback Paul Hubbard, who played for Gallaudet at the end of the nineteenth century. When his team was playing other deaf schools, he wanted to be able to keep the other team from lipreading the quarterback and spoiling the plays.

Publication History

Article published online:
29 December 2021

• References

• 1 Curthoys IS, Grant JW, Pastras CJ, Fröhlich L, Brown DJ. Similarities and Differences Between Vestibular and Cochlear Systems - A Review of Clinical and Physiological Evidence. Front Neurosci 2021; 15: 695179
• 2 Stewart CE, Bauer DS, Kanicki AC, Altschuler RA, King WM. Intense noise exposure alters peripheral vestibular structures and physiology. J Neurophysiol 2020; 123 (02) 658-669
• 3 Akin FW, Murnane OD, Tampas JW, Clinard C, Byrd S, Kelly JK. The effect of noise exposure on the cervical vestibular evoked myogenic potential. Ear Hear 2012; 33 (04) 458-465