How Concussions Impact Hearing and Balance

Brain made of little colourful blocks hearing loss concussions

By Martine Schlagintweit, M.Sc., AUD, Aud(C), RHIP

Why you should see your Audiologist after experiencing a concussion.

While the media spotlight has focused on sport-related concussions in recent years, Audiologists have been treating changes in hearing and balance resulting from concussions for the past three decades. From our experience, anyone with a concussion—including veterans, athletes, seniors, workers, and children—must treat it as an important health concern.

Concussions are a form of traumatic brain injury, which happens when the brain is shaken around inside the skull, usually following a direct blow to the head, an acceleration injury (e.g. whiplash), or exposure to a blast. Brain Injury Canada reports 160,000 Canadians experience a brain injury annually, and there are currently 1.5 million Canadians living with the effects of traumatic brain injury. 

According to Speech-Language and Audiology Canada, 40-85% of individuals who sustain concussions report some balance and hearing issues following their injury. The Ontario Neurotrauma Foundation recommends that any individual who reports changes to their hearing or balance related to a concussion should be referred to an Audiologist for evaluation. Further to this, “It is the position of Speech-Language and Audiology Canada that Audiologists are essential to quality, client-centered, interprofessional concussion care across the lifespan.”

Common hearing and balance complaints with concussions

It is common for people who have had a concussion to report consequent changes to their hearing and balance.
 
Hearing and balance symptoms of concussion include: 
  • Decreased hearing
  • Quality of sound is ‘different’ 
  • Difficulty hearing speech when other sounds are present
  • Tinnitus 
  • Sensitivity to loud sounds or certain types of sounds 
  • Feeling off balance 
  • Dizziness
  • Nausea with quick motion
  • Falls 

How do concussions affect hearing and balance? 

The initial trauma to the head, the cause of the concussion, can also cause structural damage to the organs responsible for hearing and balance, the outer middle and inner ear; this usually happens with more severe head trauma. 
 
More commonly, structures inside the brain and brainstem are impacted by the trauma, causing an array of symptoms that relate to the specific structures that have been injured. Parts of the brain that are often injured by concussion include: 
  • Corpus Callosum 
  • Thalamus & Internal Capsule 
  • Temporal Lobe 
  • Brainstem
 
Each of these regions in the brain has cells that are dedicated to supporting auditory functions like hearing speech in noise, recognizing sound patterns, localizing sounds in space, and associating a sound with a linguistic label (e.g. hearing a noise and labeling it as a ‘beep’ or a ‘boop’). Damage to these structures can make it difficult for people to make sense of sound, follow conversations, or identify where sounds are coming from, which can make participating in daily activities difficult.
 

How can Audiologists help with concussion management? 

Audiologists are key members of concussion management teams. By providing specialized diagnostic services that extend beyond the basic hearing test, Audiologists can assess the functional impact the concussion is having on a person’s hearing, auditory processing, and balance. This information is essential to evaluate the overall wellbeing of the individual after they have experienced a concussion and can be used in collaboration with other professionals including physiotherapists, occupational therapists, speech-language pathologists to develop a client-centered recovery strategy. 
 
If you or a family member are experiencing hearing or balance related issues resulting from a concussion, call us to schedule an appointment with an Audiologist. Broadmead: 250.479.2969 or Oak Bay: 250.479.2921.