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 together.

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.

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.

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 this loud.

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.

There are three individual systems (visual, vestibular, sensory) involved, but each must work with the other two in order to create balance/harmony.

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.

Sensory System 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.

The definition is "the total or partial inability to hear sound in one or both ears".

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.

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.

Hearing loss has many causes, but for our purposes as a Meniere's 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

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 MD sufferers 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. (Most of them develop a wonderful sense of humor and have great understanding of our human frailties.)

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 around now.
• 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 this disease.