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Overview of the Inner Ear

By Lawrence R. Lustig, MD, Howard W. Smith Professor and Chair, Department of Otolaryngology–Head and Neck Surgery, Columbia University Medical Center and New York Presbyterian Hospital

The fluid-filled inner ear (labyrinth) is a complex structure consisting of two major parts:

  • The organ of hearing (cochlea)

  • The organ of balance (vestibular system)

A Look Inside the Ear


The cochlea, a hollow tube coiled in the shape of a snail's shell, is filled with fluid. Within the cochlea is the organ of Corti, which consists, in part, of about 20,000 specialized cells called hair cells. These cells have small hairlike projections (cilia) that extend into the fluid. Sound vibrations transmitted from the ossicles in the middle ear to the oval window in the inner ear cause the fluid and cilia to vibrate.

Despite the protective effect of the acoustic reflex, loud noise can damage and destroy hair cells. Once a hair cell is destroyed, it does not regrow. Continued exposure to loud noise causes progressive damage, eventually resulting in hearing loss and sometimes noise or ringing in the ears (tinnitus).

Vestibular system

The vestibular system consists of two fluid-filled sacs called the saccule and the utricle and three fluid-filled tubes called the semicircular canals. These sacs and tubes gather information about the position and movement of the head. The brain uses this information to help maintain balance.

The saccule and utricle contain cells that sense movement of the head in a straight line, that is, back and forth, sensing acceleration, or up and down, sensing gravity.

The semicircular canals are three fluid-filled tubes at right angles to one another that sense rotation of the head. Rotation of the head causes the fluid in the canals to move. Depending on the direction the head moves, the fluid movement will be greater in one of the canals than in the others. The canals contain hair cells that respond to this movement of fluid. The hair cells initiate nerve impulses that tell the brain which way the head is moving so that appropriate action can be taken to maintain balance.

If the semicircular canals malfunction, which can occur in an upper respiratory infection or other temporary or permanent disorder, the person's sense of balance may be lost or a false sensation of moving or spinning (vertigo) may develop.

Disorders of the inner ear can affect hearing, balance, or both. Middle ear disorders cause many of the same symptoms, and a disorder of the middle ear may affect the inner ear and vice versa.

Inner ear disorders include

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