One of the worst parts of having Meniere's disease, can be the hearing
loss that is associated with it. It is usually just in one ear and the loss
of hearing can be very disorienting.
The Ear (For a layman's understanding)
The normal ear has three basic parts: the outer, middle, and inner ear.
The dividing point between the outer and middle ear is the tympanic
membrane, a sheet-like structure.
The middle ear houses three tiny bones "ossicles" that are linked
The inner ear is made up of two systems: auditory and vestibular. The
cochlea is a snail shaped structure and it is filled with fluid and has
hair-like sensory receptors.
- It is connected to the brain via the auditory (hearing) nerve.
- It is responsible for hearing.
The inner ear also houses the vestibular system, which is a network of
tubes and sacs. It also has hair-like sensory receptors.
- It is connected to the brain via the vestibular nerve.
- It is responsible for balance.
A very basic explanation of how the ear works.
The two functions of the ear are to capture sounds and relay them to the
brain and get interpretation. It is also responsible for balance.
Hearing: how it works.
Sound waves are received in the outer ear. They are passed through the
tympanic membrane, coming out as vibrations. They then pass over the three
bones (ossicles) to the cochlea, stirring up waves in the fluid. This motion
moves the hair-like sensory receptors. The message is translated into
electrical impulses, which are sent to the brain via the auditory nerve.
(The brain can only "read" electrical impulses.) The brain returns an
"interpretation": saying that this was a sound, and it was this intense and
The dictionary defines "balance" as a state of equilibrium, harmonious
arrangement, equal distribution.
This is what the body is trying to accomplish. It coordinates all these
systems so we stay" right side up". Each system contributes its specific
"expertise". If one isn't working correctly or is impaired, we will
experience dizziness or lightheadedness.
Balance: how it works
There are three individual systems (visual, vestibular, sensory)
involved, but each must work with the other two in order to create
Visual System. It makes us aware of our surroundings: whether we are
standing up or sitting or lying down: in relation to what else is happening.
It orientates us to our actual position.
Vestibular System. It is located in the inner ear (cochlea), is filled
with fluid, and has sensory receptors. It helps us to interpret linear and
rotational movements, such as stopping and running and adjusts as necessary.
This is why Meniere's disease may be referred to as a vestibular condition.
Is responsible for the activities of our movements. It will receive
messages from the brain to give the eyes direction as well as the muscles
and joints to carry out the required tasks, and adjusts as needed.
This helps to understand the need and significance for the different
diagnostic tests for Meniere's disease and
hearing loss. It also stresses the importance of having conclusive test
results and qualified specialists managing our care.
Hearing Loss or Impaired Hearing
The definition is "the total or partial inability to hear sound in one or
Hearing loss affects over 30 million people in North America.
With the previous explanation, hearing imbalance now makes a lot of
sense. It can be suggested that if impairment is present, then balance is
not. In order for our electrical impulses to reach the brain, both
vestibular systems (one in each ear) must be functioning properly. Balance
means both parts are working equally well. If they are not, then imbalance
occurs. This shows up as dizziness or vertigo which are both symptoms of
Groups Of Deafness/Hearing Impairments
There are many groupings of deafness / hearing impairments, but two kinds
for easy understanding are conductive and sensorineural. Sometimes both are
impaired, but often it is just one. In some people both ears are involved,
but for most, it remains with one ear.
Conductive impairment is about the mechanics of the transmission of the
sound waves. This can happen when the ossicles can't conduct sound to the
inner ear. It can also happen when the eardrum (tympanic membrane) is
blocked by excess fluid or is bulging under pressure. This is often
reparable once the underlying cause is dealt with.
The sensorineural deafness/hearing impairment involves the hair sensors
and they may be damaged. These are usually not reparable. Here are several
excellent articles on this subject.
Causes of Hearing Loss
There are many causes, but for our purposes as a Meniere's disease site,
tinnitus, is probably one of the major symptoms.
It is described as a ringing, buzzing, or roaring sound in the ear.
Generally, there is no specific treatment for tinnitus. It is a symptom
of another underlying condition. If this cause can be identified may reduce
or eliminate tinnitus.
It is interesting to note that some of the causes of tinnitus are also
causes of hearing impairment:
- damage to the nerve endings in the inner ear
- stiffening of bones in the middle ear
- exposure to loud noises
- head or neck injury
How To Live With Hearing Loss
Because so much of our world involves sound, having a hearing impairment
makes participation in many routine things a huge challenge. Add to that the
distinct possibility of vertigo or drop attacks,
the situation becomes quite unpredictable: one few people want to deal with.
It's no wonder that people with Meniere's disease become reclusive. Or at
least shy away from outside activities. Even within their own family circle,
there is often a feeling of loneliness and exclusion.
Generally people experience this loneliness only for a while.
In most cases, two things happen.
- The hearing loss is corrected and the problem disappears.
- Eventually they learn to look to themselves for happiness and
fulfillment. They accept themselves and find they are actually grateful
for the challenge. (A lot of people with Meniere's disease develop a
wonderful sense of humor and have great understanding of our human
Most will have already had a chance to participate in counseling.
Other aids could be
- Hearing aids: there are so many different styles and mechanisms
- People also need to learn to stand in such a way as to help the
sufferer be able to read their lips or watch their facial expressions.
- A quiet, relaxed environment is crucial.
- Background noise must be reduced to an acceptable level.
- Stress also must be understood
and dealt with.
- The family attitude is very important. If the hearing impaired
person is accepted and welcome, the situation will be relaxed and life
is much easier.
- It's always wise to remember that this person didn't want to have
By Karin Henderson - Nurse, Retired.