Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsTestsHow to Protect Your Ears
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Tests
How to Protect Your Ears
Inner ear problems can result in hearing loss and balance issues, which are also one of the primarycauses of vertigo.
This article will address the inner ear’s structure and function, several associated health conditions, and how to protect it.
Ear Anatomy, Function, and Care
LEONELLO CALVETTI / Getty Images
The anatomy of the inner ear is comprised of several structures, each with its own function. Each structure plays a role in hearing, balance, fluid movement within the inner ear, or a combination of the three.
Structure
Cochlea:The cochlea is a hollow bone shaped like a snail. A membrane divides it into two fluid-filled chambers. When sound enters the chambers, it causes the tiny hairs lining the membrane to vibrate and send electrical impulses (sound signals) to the brain.
The cochlea is about 9 millimeters wide at its widest point and about 5 millimeters tall. If it could be uncoiled, it would be about 30 millimeters long.
The membrane between the cochlear duct and thescala tympani—also known as the basilar membrane—is located in the primary hearing organ, the Organ of Corti. The upper membrane, called Reissner’s membrane, helps control fluid flow from the duct to the scala vestibuli.
Semicircular ducts:This is where fluid, called endolymph, changes speed and direction when you move your head. Sensory receptors in these ducts detect this change and send information to your brain to help you maintain balance.
The final structural pieces of the inner ear are the seventh and eighth cranial nerves, which carry information about sound and balance to the brain:
Cranial nerve 7:Also called the facial nerve, this nerve provides information to the brain on sensory and motor functions. One section of the nerve controls the motor function of part of the face, and the other controls sensory information related to taste and hearing. Specifically, this nerve carries information to the brain from the tympanic membrane.
Cranial nerve 8:Another cranial nerve, the eighth cranial nerve, is also called thevestibulocochlearnerve. It combines vestibular and cochlear nerve fibers. The vestibular nerve fibers provide information to the brain about balance, while the cochlear nerve fibers carry information about sound. Both are sensory nerve fibers. Damage to this nerve could impact both hearing and balance.
What Black Earwax Means
Location
The temporal lobe of the brain, also housed in the temporal bone, is above the inner ear. This is the portion of the brain that processes sound and speech, as well as some vision, emotion, and memory.
Anatomical Variations
The purpose of the inner ear is to sense and process information about sound and balance and send that information to the brain. Each part of the inner ear has a specific function.
Cochlea:The cochlea is responsible for hearing. It comprises several layers, with theOrgan of Cortiat the center. This is the portion of the cochlea that is lined with tiny hairs called cilia. Cilia move as sound waves pass through the fluid in the cochlea. This movement is translated into an electric impulse passed from the inner ear to the brain through the eighth cranial nerve.
Semicircular canals:Semicircular canals are a three-loop system that uses fluid shifts in the inner ear to give the brain information about balance, motion, and how the head is positioned relative to surroundings.
The first canal is responsible for sensing up-and-down movement. The second canal senses side-to-side movements. The third canal signals to the brain when the head is tilted. Each canal contains fluid and tiny hairs. As the movement of the head causes fluid shifts through the canals, these tiny hairs send messages to the brain through the seventh cranial nerve.
Vestibule:The primary function of the vestibule is to detect changes in gravity and up-and-down movement. For example, it is responsible for sensing if you are standing up straight or upside-down.
How Do We Hear?
Several ear parts work together to collect and transmit sound and movement to the brain.
How Does Our Sense of Balance Work?
Besides sound, the inner ear is also responsible for our balance and sense of body positioning. The semicircular canals are responsible for interpreting which direction the head is moving. The twootolithorgans in your inner ear are responsible for your sense of moving forwards, backward, side-to-side, and up and down.This balance system is also known as the vestibular system.
When the body receives mixed messages from the semicircular canals or otolith organs, it can feel dizzy or nauseous. A typical example is sea sickness. Your vestibular system may sense that you are rocking side to side. However, your eyes may perceive you standing straight and not rocking. This can cause several symptoms associated with sea sickness, such as nausea and dizziness.
A number of conditions can result from problems within the middle ear. Most of these problems involve hearing loss or a disruption of balance.
When hearing loss is the problem, the symptoms should be clear. Hearing can be reduced or even gone completely. When inner ear problems cause balance issues, the symptoms may include:
Specific conditions that can result from problems in the inner ear include:
Hearing Loss
Problems with the inner ear’s function or structure can cause hearing loss or reduction.
Treatment
Treatment depends on the cause of the hearing loss. If the problem lies in the structure of the cochlea, acochlear implantmay be able to help. In other cases of hearing loss, treatments vary, buthearing aidscan help reduce the impact of the problem.
Acoustic Neuroma
Anacoustic neuromais a slow-growing, noncancerous tumor that forms on the nerve that runs from the inner ear to the brain. In some cases, the tumor may grow large enough that it puts pressure on the nerve and causes symptoms like dizziness, hearing loss, balance problems, ortinnitus(ringing in the ear).
Since these tumors are often slow-growing and don’t spread to other organs, your healthcare provider may monitor their growth and symptoms. If the tumor begins to cause problems, radiation and surgical removal of the tumor may be recommended.
Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo(BPPV) is also known as positional vertigo. It is the most common form of vertigo and can result in intense dizziness with a change in the position of the head. There is no real known cause for this condition outside of a head injury. Symptoms rarely become serious and are more annoying or uncomfortable.
Your healthcare provider may use one of two main repositioning techniques to reduce your symptoms. If you cannot do either of the techniques or choose not to, there are exercises your provider can teach you to do at home that may help.
Alternatively, surgery may be an option if the repositioning or exercises are ineffective. The procedure involves destroying nerve fibers in the semicircular canal or the entire semicircular canal. Both surgical procedures prevent the sensory hairs from sending signals to the brain, which can result in vertigo.
Ménière’s Disease
Ménière’sdisease involves the pressure of the fluid in the inner ear. Although the exact cause of this disease isn’t known, the development of Ménière’s disease has been linked to poor fluid drainage, an abnormal immune response, family history, or viral infections. Ménière’s disease usually begins in one ear but can sometimes spread to both ears. Symptoms include vertigo and dizziness, hearing loss, tinnitus, and intense feelings of pressure or fullness in the ear.
Treatments center on symptom management, such as using medications to control nausea or dizziness. Your healthcare provider may also recommend dietary changes, diuretics, cognitive therapy, or pressure pulse therapy to alleviate your symptoms. In severe cases, surgery may reduce the amount of fluid in the inner ear and relieve pressure.
Treatment for this problem involves treating the underlying viral cause, if there is one, managing symptoms like nausea or dizziness, and therapies to help restore balance.
Superior Semicircular Canal Dehiscence
Superior semicircular canal dehiscence(SSCD) is a rare condition where the bony area that covers the semicircular canal is reduced or absent altogether. Symptoms of this condition include vertigo, hearing loss, a feeling of pressure in the ears, and even problems blinking or breathing.
This condition can be repaired with surgery to fill and resurface the area of missing bone.
When To Seek HelpHearing problems can become serious or dangerous when you can’t hear things like:Safety informationOncoming trafficEmergency signalsBalance problems are often more emergent since issues with your vestibular system can cause falls and lead to injury.If you are experiencing any of these symptoms, reach out to a healthcare provider.
When To Seek Help
Hearing problems can become serious or dangerous when you can’t hear things like:Safety informationOncoming trafficEmergency signalsBalance problems are often more emergent since issues with your vestibular system can cause falls and lead to injury.If you are experiencing any of these symptoms, reach out to a healthcare provider.
Hearing problems can become serious or dangerous when you can’t hear things like:
Balance problems are often more emergent since issues with your vestibular system can cause falls and lead to injury.
If you are experiencing any of these symptoms, reach out to a healthcare provider.
Testing for inner ear problems focuses on checking for structural problems, hearing loss, or balance issues. When the inner ear’s structure is suspected to be causing a problem, imaging tests likecomputed tomography(CT) ormagnetic resonance imaging(MRI) are most effective at identifying the origin of the issue.
Anaudiologistmay perform a series of exams using different sounds and tones to test your hearing, including:
For balance, testing is slightly different and usually involves a series of tests. You may undergo one of the following exams:
Vestibular testing:This includes a series of examinations to test how well your vestibular system works, includingelectronystagmographyorvideonystagmography. Both of these tests record eye movements in different situations, and these movements can provide clues to the function of the inner ear.
Most forms of vestibular testing can worsen vertigo or dizziness, so it’s a good idea to bring someone to drive you home after the test.
Computerized dynamic posturography:This test evaluates three senses—vestibular, somatosensory, and vision. When these senses are functioning well together, you have good balance.
This test, combined with the results of other tests, allows your healthcare provider to evaluate which sense is not functioning and target treatment. During this test, you will stand on a platform barefoot, secured with a safety harness. Your balance will then be tested in a variety of situations.
Vestibular evoked myogenic potential:Electrodes are placed on your forehead, under your eyes, on your neck, and on your collarbone. Headphones are placed in your ear, and a loud clicking noise is played while you look up or over your shoulder. How strongly you respond to the sound will indicate how well your vestibular cranial nerves function.
Video head impulse testing:Special goggles are placed on your face, and you are asked to track targets with your eyes. An audiologist then produces specific movements to stimulate different parts of the inner ear, measuring and comparing your response to the various movements.
What Causes a Balance Problem, and What Can You Do About It?
Contact your healthcare provider if you are concerned about your hearing or balance. These tests can provide your practitioner with information to determine what your next steps should be.
There are several steps you can take to maintain ear health. These include measures to keep your ears clean and healthy and methods to protect your ears from preventable hearing loss.
Clean Your Ears
Ear wax helps keep your ears healthy. However, some individuals may produce more wax than others. This can cause problems if the wax becomes impacted or hardened. Fortunately, you can use several safe methods to soften the wax and clean your ears.
If your eardrum may have a hole in it or you have had recent ear surgery, consult your healthcare provider before attempting to clean your ear.
Substances you can use to try and soften ear wax include:
Place a few drops of your method of choice into your ear with a dropper.
You can also try washing your ear with body-temperature warmed water or saline. Using room temperature or chilled water may make you dizzy. However, talk to your healthcare provider before doing this on your own. Kits are available for home use.
When to Use CautionSeveral conditions can make cleaning your ears yourself riskier. If you have any of the following conditions, consult your healthcare provider before cleaning your ears out on your own:DiabetesEardrum holeEar tubesEczema of the ear canalOther skin conditions affecting the ear canalWeakened immune systemDepending on your health condition, your healthcare provider may be able to remove ear wax manually using special tools.
When to Use Caution
Several conditions can make cleaning your ears yourself riskier. If you have any of the following conditions, consult your healthcare provider before cleaning your ears out on your own:DiabetesEardrum holeEar tubesEczema of the ear canalOther skin conditions affecting the ear canalWeakened immune systemDepending on your health condition, your healthcare provider may be able to remove ear wax manually using special tools.
Several conditions can make cleaning your ears yourself riskier. If you have any of the following conditions, consult your healthcare provider before cleaning your ears out on your own:
Depending on your health condition, your healthcare provider may be able to remove ear wax manually using special tools.
Safely Unclog Your Ears
You may experience fullness and ear pain when you have a cold or congestion. This is because there areeustachiantubes in each of your ears. When you’re sick, they can swell and block fluid from draining appropriately.
Fortunately, there are several measures you can take to help relieve pressure in your ears. These measures include:
Protect Your Ears
It is vital to protect your ears from preventable hearing loss. Sound is measured in a unit called decibels (dBA). Prolonged or repeated exposure to decibels at or above 85 dBA can cause hearing loss. For context, a normal conversation is around 60-70 dBA. A lawnmower averages 80-100 dBA, and a sports event tends to be between 94-110 dBA.
Consider wearing ear protection if you are exposed to loud sounds, especially for extended periods. Also, be aware of how loud your music is.
Summary
The inner ear plays a vital role in your ability to hear and balance. Several conditions may affect the inner ear, with treatment options available to lessen symptoms and reduce hearing loss.
If you experience hearing loss or health issues related to your inner ear, healthcare providers may perform one of several tests to determine the source of the problem. They can then determine the best treatment plan for your condition.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NIDCD.How do we hear?Merck Manual Professional Version.Introduction to Inner Ear Disorders.Neuroscience Online.Vestibular System: Structure and Function.Teach Me Anatomy.The Inner Ear.Teach Me Anatomy.The Facial Nerve.Teach Me Anatomy.The Vestibuloicocchear Nerve.Teach Me Anatomy.The Cerebrum.Sennaroğlu L, Bajin MD.Classification and current management of inner ear malformations.Balkan Med J; 34(5):397-411.American Speech-Language-Hearing Association.Dizziness and Balance.Institute for Quality and Efficiency in Health Care (IQWiG).In Brief: How Does Our Sense of Balance Work?2023.Greene J, Al-Dhahir MA. Acoustic neuroma. In: StatPearls. StatPearls Publishing; 2024.Institute for Quality and Efficiency in Health Care (IQWiG).Benign paroxysmal positional vertigo: Learn More – What can you do if you have BPPV?InformedHealth.org - NCBI Bookshelf. Published October 4, 2023.National Institute on Deafness and Other Communication Disorders.What is Ménière’s Disease? — diagnosis and treatment.Smith T, Rider J, Cen S, Borger J.Vestibular neuronitis.In: StatPearls. StatPearls Publishing; 2024.Johns Hopkins.Superior Canal Dehiscence Syndrome.MedlinePlus.Hearing tests for adults.University of Chicago Medicine.Inner Ear Balance (Vestibular) Disorders.MedlinePlus.Ear wax.ENT Health.Earwax (Cerumen impaction) - ENT Health.ENT Health. Published April 24, 2024.MyHealth.Alberta.ca.Eustachian tube problems: care instructions.NIDCD.Do you know how loud is too loud?
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NIDCD.How do we hear?Merck Manual Professional Version.Introduction to Inner Ear Disorders.Neuroscience Online.Vestibular System: Structure and Function.Teach Me Anatomy.The Inner Ear.Teach Me Anatomy.The Facial Nerve.Teach Me Anatomy.The Vestibuloicocchear Nerve.Teach Me Anatomy.The Cerebrum.Sennaroğlu L, Bajin MD.Classification and current management of inner ear malformations.Balkan Med J; 34(5):397-411.American Speech-Language-Hearing Association.Dizziness and Balance.Institute for Quality and Efficiency in Health Care (IQWiG).In Brief: How Does Our Sense of Balance Work?2023.Greene J, Al-Dhahir MA. Acoustic neuroma. In: StatPearls. StatPearls Publishing; 2024.Institute for Quality and Efficiency in Health Care (IQWiG).Benign paroxysmal positional vertigo: Learn More – What can you do if you have BPPV?InformedHealth.org - NCBI Bookshelf. Published October 4, 2023.National Institute on Deafness and Other Communication Disorders.What is Ménière’s Disease? — diagnosis and treatment.Smith T, Rider J, Cen S, Borger J.Vestibular neuronitis.In: StatPearls. StatPearls Publishing; 2024.Johns Hopkins.Superior Canal Dehiscence Syndrome.MedlinePlus.Hearing tests for adults.University of Chicago Medicine.Inner Ear Balance (Vestibular) Disorders.MedlinePlus.Ear wax.ENT Health.Earwax (Cerumen impaction) - ENT Health.ENT Health. Published April 24, 2024.MyHealth.Alberta.ca.Eustachian tube problems: care instructions.NIDCD.Do you know how loud is too loud?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
NIDCD.How do we hear?Merck Manual Professional Version.Introduction to Inner Ear Disorders.Neuroscience Online.Vestibular System: Structure and Function.Teach Me Anatomy.The Inner Ear.Teach Me Anatomy.The Facial Nerve.Teach Me Anatomy.The Vestibuloicocchear Nerve.Teach Me Anatomy.The Cerebrum.Sennaroğlu L, Bajin MD.Classification and current management of inner ear malformations.Balkan Med J; 34(5):397-411.American Speech-Language-Hearing Association.Dizziness and Balance.Institute for Quality and Efficiency in Health Care (IQWiG).In Brief: How Does Our Sense of Balance Work?2023.Greene J, Al-Dhahir MA. Acoustic neuroma. In: StatPearls. StatPearls Publishing; 2024.Institute for Quality and Efficiency in Health Care (IQWiG).Benign paroxysmal positional vertigo: Learn More – What can you do if you have BPPV?InformedHealth.org - NCBI Bookshelf. Published October 4, 2023.National Institute on Deafness and Other Communication Disorders.What is Ménière’s Disease? — diagnosis and treatment.Smith T, Rider J, Cen S, Borger J.Vestibular neuronitis.In: StatPearls. StatPearls Publishing; 2024.Johns Hopkins.Superior Canal Dehiscence Syndrome.MedlinePlus.Hearing tests for adults.University of Chicago Medicine.Inner Ear Balance (Vestibular) Disorders.MedlinePlus.Ear wax.ENT Health.Earwax (Cerumen impaction) - ENT Health.ENT Health. Published April 24, 2024.MyHealth.Alberta.ca.Eustachian tube problems: care instructions.NIDCD.Do you know how loud is too loud?
NIDCD.How do we hear?
Merck Manual Professional Version.Introduction to Inner Ear Disorders.
Neuroscience Online.Vestibular System: Structure and Function.
Teach Me Anatomy.The Inner Ear.
Teach Me Anatomy.The Facial Nerve.
Teach Me Anatomy.The Vestibuloicocchear Nerve.
Teach Me Anatomy.The Cerebrum.
Sennaroğlu L, Bajin MD.Classification and current management of inner ear malformations.Balkan Med J; 34(5):397-411.
American Speech-Language-Hearing Association.Dizziness and Balance.
Institute for Quality and Efficiency in Health Care (IQWiG).In Brief: How Does Our Sense of Balance Work?2023.
Greene J, Al-Dhahir MA. Acoustic neuroma. In: StatPearls. StatPearls Publishing; 2024.
Institute for Quality and Efficiency in Health Care (IQWiG).Benign paroxysmal positional vertigo: Learn More – What can you do if you have BPPV?InformedHealth.org - NCBI Bookshelf. Published October 4, 2023.
National Institute on Deafness and Other Communication Disorders.What is Ménière’s Disease? — diagnosis and treatment.
Smith T, Rider J, Cen S, Borger J.Vestibular neuronitis.In: StatPearls. StatPearls Publishing; 2024.
Johns Hopkins.Superior Canal Dehiscence Syndrome.
MedlinePlus.Hearing tests for adults.
University of Chicago Medicine.Inner Ear Balance (Vestibular) Disorders.
MedlinePlus.Ear wax.
ENT Health.Earwax (Cerumen impaction) - ENT Health.ENT Health. Published April 24, 2024.
MyHealth.Alberta.ca.Eustachian tube problems: care instructions.
NIDCD.Do you know how loud is too loud?
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
