Traumatic brain injuries (TBI) can lead to a variety of hearing and balance issues, including ringing in the ears, dizziness, and hearing loss, according to information released on Mar. 11.
These complications may not be immediately apparent after an injury. Experts say that initial medical care for TBI focuses on stabilizing the patient, which can delay the identification of auditory problems until patients or their families notice symptoms. Shahrzad Cohen, an audiologist based in Sherman Oaks, California, said in a webinar for the Hearing Loss Association of America that often there is a delay until “the patient reports signs and symptoms of audiological disorders or family members start noticing the signs.”
A traumatic brain injury is defined as head trauma that temporarily impairs normal brain function. Falls are responsible for nearly half of all TBIs in the United States, with car crashes and assaults also contributing. Older adults are at higher risk for serious outcomes from these injuries.
Auditory issues following TBI can include tinnitus (ringing in the ears), asymmetrical hearing loss or "double hearing," noise sensitivity, decreased sound tolerance, aural fullness, and auditory processing problems. Vestibular symptoms such as dizziness and vertigo are also common. More than half of TBI patients develop tinnitus, especially those exposed to blasts. “The phantom sounds—which range from hissing to buzzing—are the first and most reported issue with traumatic brain injury,” Cohen said. She added that “it is a major issue for our patients.” Among retired military service members, tinnitus is the leading reason veterans file for compensation disability.
Hearing loss related to TBI may result from damage at various points within the ear or auditory system—from torn eardrums and damaged ossicular bones to nerve injuries or changes within the cochlea or deep brain regions responsible for processing sound. Some cases involve lingering inflammation or microscopic nerve fiber tears that standard imaging cannot detect but may still cause ongoing symptoms.
Treatment depends on the specific symptom and its cause; ruptured eardrums may heal naturally while surgical repair might be needed for damaged bones. Hearing aids with tinnitus masking features can help many people manage persistent symptoms alongside therapies like cognitive-behavioral therapy.
Experts recommend anyone with a history of head trauma inform their doctor about any current hearing or balance issues so they receive appropriate evaluation and care.
