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Inner Ear Trauma - Symptoms, Causes, and Treatment

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The inner ear plays a major role in maintaining balance. Sometimes during a head injury from an accident or a fall, the inner ear can get injured.

Medically reviewed by

Dr. Satyabrata Panigrahi

Published At January 13, 2023
Reviewed AtJuly 10, 2023

What Is Inner Ear Injury?

Injuries can happen to the inner ear, middle ear, or outer ear, which is the part of the ear that is visible outside. Trauma, like a blow to the head, can result in damage to the inner (deepest part of the ear) or the middle ear (the part of the ear behind the eardrum). An ear injury can be caused by loud noises, changes in air pressure, or foreign objects introduced into the ear.

The accidents can damage the ear canal, eardrum, cartilage the skin around the ear. These injuries can cause bleeding, ear pain, balance problems, and hearing loss. Severe injury can be life-threatening too. If a person sees bleeding from the ear after a head injury, seek medical attention immediately.

How Does the Inner Ear Work?

  • The inner ear consists of two main structures; the vestibular system and the cochlea.

  • The vestibular system is responsible for balance, whereas the cochlea is responsible for hearing.

  • The anatomy of the inner ear comprises a large fluid-filled space and a complex series of tubes that run into the temporal bone of the skull.

  • The sound is collected by the outer ear and is channeled through the ear canal to the eardrum in the middle ear.

  • The small bones in the middle ear vibrate and are transmitted to the inner ear. The inner ear amplifies the sound and converts it into electrical signals, and sends it to the brain via the vestibulocochlear nerve.

What Are the Symptoms of Inner Ear Injury?

The inner ear injury can affect the vestibular component, or the cochlear component, or both. The symptoms will depend on the structure involved, and they are:

  • Dizziness.

  • Vertigo (a sensation that you or the environment around is moving or spinning).

  • Lightheadedness.

  • Balance-related problems.

  • Coordination problems.

  • Difficulty in maintaining an upright position.

  • Hearing loss or reduced hearing.

  • Sensitivity to noises.

  • Tinnitus (constant ringing sound in the ear).

  • Unclear vision.

  • Neck pain.

These symptoms will vary from person to person and will depend upon the extent of the injury. These symptoms can be temporary or permanent.

What Causes Inner Ear Injury?

The common causes of inner ear injury are trauma to the ear, loud noises, changing air pressure, and head injury.

  • Head Injury- The head injury can occur during road accidents or by falling from a height and can cause a perilymph fistula. Perilymph fistula is an abnormal connection between the inner ear, which contains the fluid and the middle ear containing the air. This connection will result in peri lymphatic leaking into the middle ear. The symptoms of the perilymph fistula and the traumatic brain injury are similar and need a consultation with a neurologist to confirm the diagnosis.

  • Loud Noise- Prolonged exposure to loud noise can cause injury to the inner ear. People who work in industries with heavy machinery and construction sites are prone to such injuries, as they are exposed to loud noise most of the time during the day. The injury can also occur in case of explosions where the ear is subjected to loud noise for a single time.

How Is Inner Ear Injury Treated or Managed?

The treatment for the inner ear injury will depend upon the symptoms the patient has, the age of the patient, and the affected structure of the ear. The treatment would include the following:

1) Vestibular Therapy is advised for patients with balance problems following the injury. It is an exercise done to improve balance issues and vertigo. There are a set of exercises under vestibular therapy, and they are:

  • Vision stability training.

  • Posture training.

  • Exercises like stretching and strengthening.

  • Balance retraining.

  • Walking exercises.

  • Neck mobility or stretching exercises.

  • General fitness exercises at home will help prevent the recurrence of the condition and aid in better results. The duration of these exercises may range from six to eight weeks, in which you have to go at least two times a week. But this will vary depending upon the severity of the condition and the response to the therapy.

  • Ergonomic training.

  • Ossiculoplasty is a type of surgery done to repair the tiny bones that are the ossicles inside the bone.

  • Tympanoplasty is the surgical procedure done to patch the torn eardrum. It is done only in severe cases of eardrum rupture.

  • Hearing aids are advised for patients with hearing problems. Cochlear implants are given in case of damage to the cochlea, which will help stimulate the auditory nerve to provide the sensation of sound. These implants are placed surgically by a surgeon in the ear. This device bypasses the damaged part of the inner ear to stimulate the nerve directly so that the patients can hear. These implants do not help to hear, but they provide the sensation of sound for those who are hard of hearing. There are two components of cochlear aids; the external component has a microphone, speech processor, and transmitter, and the internal component that has a receiver and an electrode array that is implanted in the inner ear. The sound is gathered from the microphone, and the speech processor transmits it to the receiver, which then converts it into electrical pulses and then delivered it to the electrodes, which then stimulate the auditory nerve the brain receives the signal and then processes it to perceive the information.

Conclusion

The inner ear injury can occur as an outcome of an accident, sudden loud noise, and a head injury. It needs medical attention right away as the condition can worsen over time when not treated. The symptoms of this condition will vary according to the structure injured, and the symptom can also be indicative of injury to other parts of the head, as in the case of head injury. So never ignore the signs of inner ear injury.

Frequently Asked Questions

1.

Can Inner Ear Injury Repair Itself?

The extent of inner ear injury depends on the cause. The inner ear cells can get damaged by exposure to loud noise. But, within hours, they can repair themselves. The breaking of cell links is one of the causes of temporary hearing loss after a loud blast or a concert. However, it depends on the extent of the injury. 

2.

Is Dizziness Related to Inner Ear Injury?

Dizziness can be a symptom of inner ear diseases. Common causes of dizziness related to the inner ear are benign paroxysmal positional vertigo (BPPV), migraine, and inflammation of the eighth cranial nerve (vestibular neuritis). Inner ear symptoms such as hearing loss, dizziness, or tinnitus (ringing sensation in the ears) can develop after head injury. Moreover, direct injuries to the inner ear can also lead to inner ear symptoms. 

3.

How Is the Headache Related to Inner Ear Infection Felt?

A dull and aching pain on the side of the head, face, or jaw can indicate an inner ear infection (labyrinthitis) or a vestibular migraine (a type of migraine that leads to vertigo and dizziness).  Labyrinthitis is the inflammation of the ear components responsible for balance and hearing. It causes earache, headaches, tinnitus, ear discharge, and blurred or double vision. 

4.

Does an Ear Infection Require Homestay?

Many ear infections resolve within a week. If a person has a fever or is unwell, staying home is a good option. However, it should be noted that ear infections are not contagious. One can return to normal activities after the pain and fever subside. Further, one should continue taking the prescribed antibiotics and analgesics. 

5.

Which Specialist Manages Inner Ear Issues?

An ENT specialist (otolaryngologist) is a doctor who specializes in diseases of the ears, nose, and throat. Suppose one suffers from ear symptoms such as hearing loss, balance issues, tinnitus, and vertigo. In that case, the specialist will record a proper history, conduct a careful clinical examination, and conduct many investigations. 

6.

Can Tincture Iodine Be Used in Inner Ear Injury?

Pre-surgical antiseptics can reduce wound infections when used safely. Tincture iodine is a commonly used disinfectant in head and neck surgeries. However, there is not much data regarding the safety of tincture iodine preparation inside the ear. Still, it is a local antiseptic (topical) for surface disinfection in external and middle ear infections. 

7.

How to Detect Permanent Ear Damage?

Ear damage can be detected by 
- Clinical Examination: The ENT specialist performs a thorough clinical examination of the ear. 
- Screening tests: A whisper test, which involves covering one ear at a time while listening to words spoken at many volumes, can show how you react to other sounds.
- Audiometry: An audiologist (a professional with training in hearing and balance) performs audiometry tests. Audiometry tests the ability to hear sounds based on their intensity and tone. 

8.

Is Vestibular Nerve Damage Repairable?

Vestibular nerve inflammation (vestibular neuritis) is mainly caused by a virus infection that affects the inner ear. In many people with vestibular neuritis, symptoms improve within some weeks. But, there are other treatment options for chronic (long-lasting) cases. However, it should be noted that the vestibular nerve cannot repair itself. 

9.

Describe the Best Treatment Option for Inner Ear Infection.

Inner ear infections can cause inner ear inflammation. These can affect a person’s hearing and balance. They can occur when a person has a cold or after the spread of a middle ear infection. Antibiotics are medicines prescribed by the doctor to ward off the infection. They are the best way of clearing and preventing a bacterial infection from spreading to other body parts.

10.

Can Sudden and Loud Sound Damage the Ear?

Loud noise can harm the inner ear structures, especially the cochlea (a sensitive inner ear bone involved in hearing). A single exposure to extremely loud or chronic exposure to loud sounds can cause hearing loss. This is because the loud noise can damage cochlear cells and membranes. 

11.

Which Neurological Disorders Damage the Ear?

Neurological disorders include a group of conditions that affect the inner ear. Examples are acoustic neuroma (a nerve tumor), benign paroxysmal positional vertigo (BPPV; occurs due to calcium deposits in the inner ear), cochlear hydrops (increase in the fluid affecting the cochlea), and Meniere’s disease (an inner ear disease).
Dr. Satyabrata Panigrahi
Dr. Satyabrata Panigrahi

Audiology

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