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The ears are very much related to balance and dizziness.

Balance is maintained not only by the vestibular system found in your ears but also by your visual and sensory systems. If any one of these systems is damaged, you may experience dizziness or loss of balance.

Yet I'm not finding anything out about the role of deafness in 5E combat particularly regarding melee.

I know if I were DM'ing I'd probably give a negative to hit for Strength / 2handed weapon use, and full disadvantage for finesse weapons. Or maybe to simplify things give a percentage roll with like a 20% chance of falling down on a missed attack... something anyways to show the character is having issues.

But are there any Rules or Guidelines regarding how deafness affects melee combat?

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Deafened is a specific Condition called out in page 290 of the PHB:

Deafened

  • A deafened creature can't hear and automatically fails any ability check that requires hearing.

Given that spells only do what they say they do and nothing more (I'm assuming the Deafened condition was cause by a spell), that appears to be all. By RAW, there are no balancing issues, no penalties to hit or anything like that.

There are rare adverse effects such as they cannot benefit from Bardic Inspiration.

There are even rarer benefits as well, such as they won't be affected by spells that require them to hear, like Dissonant Whispers (strangely, Command does not need a creature to hear).

In summary, becoming deafened isn't very threatening; it's much better to blind a melee combatant, instead.

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  • \$\begingroup\$ "Command does not need a creature to hear" Are you sure about that? It requires them to understand your language. See: roll20.net/compendium/dnd5e/Command#content \$\endgroup\$
    – Rob Rose
    Nov 23, 2017 at 22:28
  • \$\begingroup\$ @RobRose I am sure. There is nothing in Command that says that deafened creatures are immune, unlike Dissonant Whispers. That's why I said "strangely", as Command was the first spell that came to mind that sounded like a deafened creature should be immune. Given that inconsistency, I like to think that Command is more of a telepathic command rather than a verbal one. \$\endgroup\$
    – daze413
    Nov 24, 2017 at 0:37
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    \$\begingroup\$ Strange, indeed, that with a spell description including "you speak a one-word command" and "components: V", one doesn't have to be heard to successfully use the Command spell! \$\endgroup\$
    – Meta4ic
    Nov 24, 2017 at 2:27
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    \$\begingroup\$ I would think that understanding your language requires hearing it though. (Unless you can speak telepathically of course) \$\endgroup\$
    – Rob Rose
    Nov 24, 2017 at 3:21
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    \$\begingroup\$ As the author of the question you're referencing to, "spells only do what they say they do and nothing more" isn't quite correct. The DMG itself has examples which contradict this ".. and nothing more" interpretation. I'd say the answer is "spells only do what they say they do plus anything what your GM says". JC's twitter confirms this. \$\endgroup\$
    – enkryptor
    Jan 21, 2018 at 21:00
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"Deafness" does not automatically imply balance problems. Yes, there's a correlation, because an issue that affects the cochlea might also affect the vestibular system, as they're located so close together. From what I can find, about 30% of deaf people experience balance impairments... but that also means that 70% don't. So even from a simulationist perspective (let alone RAW), the most sensible default is to assume that a deafness effect does not cause balance problems unless explicitly stated.

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