Otology
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Otology
Otology is a branch of medicine which studies normal and pathological anatomy and physiology of the ear (hearing and vestibular sensory systems and related structures and functions) as well as their diseases, diagnosis and treatment. Otologic surgery generally refers to surgery of the middle ear and mastoid related to chronic otitis media, such as tympanoplasty, or ear drum surgery, ossiculoplasty, or surgery of the hearing bones, and mastoidectomy. Otology also includes surgical treatment of conductive hearing loss, such as stapedectomy surgery for otosclerosis. Neurotology, a related field of medicine and subspecialty of otolaryngology, is the study of diseases of the inner ear, which can lead to hearing and balance disorders. Neurotologic surgery generally refers to surgery of the inner ear or surgery that involves entering the inner ear with risk to the hearing and balance organs, including labyrinthectomy, cochlear implant surgery, and surgery for tumors of the temporal ...
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Neurotology
Neurotology or neuro-otology is a subspecialty of otolaryngology—head and neck surgery, also known as ENT (ear, nose, and throat) medicine. Neuro-otology is closely related to otology, clinical neurology and neurosurgery. Otology may refer to ENT physicians who "... tudynormal and pathological anatomy and physiology of the ear (hearing and vestibular sensory systems and related structures and functions) ...", and who treat diseases of the ear with medicine or surgery. In some instances, otology and neurotology are considered together—as so closely related that a clear demarcation between the subspecialties might not exist. For example, the University of Maryland Medical Center uses the term, "otologist/neurotologist". Otologists and neurotologists have specialized in otolaryngology and then further specialized in pathological conditions of the ear and related structures. Many general otolaryngologists are trained in otology or middle ear surgery, performing surgery such a ...
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Cochlear Implant
A cochlear implant (CI) is a surgically implanted neuroprosthesis that provides a person who has moderate-to-profound sensorineural hearing loss with sound perception. With the help of therapy, cochlear implants may allow for improved speech understanding in both quiet and noisy environments. A CI bypasses acoustic hearing by direct electrical stimulation of the auditory nerve. Through everyday listening and auditory training, cochlear implants allow both children and adults to learn to interpret those signals as speech and sound. The implant has two main components. The outside component is generally worn behind the ear, but could also be attached to clothing, for example, in young children. This component, the sound processor, contains microphones, electronics that include digital signal processor (DSP) chips, battery, and a coil that transmits a signal to the implant across the skin. The inside component, the actual implant, has a coil to receive signals, electronics, and an ...
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Otology
Otology is a branch of medicine which studies normal and pathological anatomy and physiology of the ear (hearing and vestibular sensory systems and related structures and functions) as well as their diseases, diagnosis and treatment. Otologic surgery generally refers to surgery of the middle ear and mastoid related to chronic otitis media, such as tympanoplasty, or ear drum surgery, ossiculoplasty, or surgery of the hearing bones, and mastoidectomy. Otology also includes surgical treatment of conductive hearing loss, such as stapedectomy surgery for otosclerosis. Neurotology, a related field of medicine and subspecialty of otolaryngology, is the study of diseases of the inner ear, which can lead to hearing and balance disorders. Neurotologic surgery generally refers to surgery of the inner ear or surgery that involves entering the inner ear with risk to the hearing and balance organs, including labyrinthectomy, cochlear implant surgery, and surgery for tumors of the temporal ...
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Ménière's Disease
Ménière's disease (MD) is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. Typically, only one ear is affected initially, but over time, both ears may become involved. Episodes generally last from 20 minutes to a few hours. The time between episodes varies. The hearing loss and ringing in the ears can become constant over time. The cause of Ménière's disease is unclear, but likely involves both genetic and environmental factors. A number of theories exist for why it occurs, including constrictions in blood vessels, viral infections, and autoimmune reactions. About 10% of cases run in families. Symptoms are believed to occur as the result of increased fluid buildup in the labyrinth of the inner ear. Diagnosis is based on the symptoms and a hearing test. Other conditions that may produce similar symptoms include vestibular migraine and transient ischemi ...
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Acoustic Neuromas
A vestibular schwannoma (VS), also called acoustic neuroma, is a benign tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. The tumor originates when Schwann cells that form the insulating myelin sheath on the nerve malfunction. Normally, Schwann cells function beneficially to protect the nerves which transmit balance and sound information to the brain. However, sometimes a mutation in the tumor suppressor gene, NF2, located on chromosome 22, results in abnormal production of the cell protein named ''Merlin'', and Schwann cells multiply to form a tumor. The tumor originates mostly on the vestibular division of the nerve rather than the cochlear division, but hearing as well as balance will be affected as the tumor enlarges. The great majority of these VSs (95%) are unilateral, in one ear only. They are called "sporadic" (i.e., by-chance, non-hereditary). Although non-cancerous, they can do harm or even become life-threatening if they grow ...
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Otolaryngology
Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of skull, base of the skull, head, and neck. These commonly include functional diseases that affect the senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management of cancers and benign tumors and reconstruction of the head and neck as well as plastic surgery of the face and neck. Etymology The term is a combination of New Latin classical compound, combini ...
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Otosclerosis
Otosclerosis is a condition of the middle ear where portions of the dense enchondral layer of the bony labyrinth remodel into one or more lesions of irregularly-laid spongy bone. As the lesions reach the stapes the bone is resorbed, then hardened ( sclerotized), which limits its movement and results in hearing loss, tinnitus, vertigo or a combination of symptoms. The term otosclerosis is something of a misnomer: much of the clinical course is characterized by lucent rather than sclerotic bony changes, so the disease is also known as otospongiosis. Etymology The word ''otosclerosis'' derives from Greek ὠτός (''ōtos''), genitive of οὖς (''oûs'') "ear" + σκλήρωσις (''sklērōsis''), "hardening". Presentation The primary form of hearing loss in otosclerosis is conductive hearing loss (CHL) whereby sounds reach the ear drum but are incompletely transferred via the ossicular chain in the middle ear, and thus partly fail to reach the inner ear (cochlea). This can af ...
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Tinnitus
Tinnitus is the perception of sound when no corresponding external sound is present. Nearly everyone experiences a faint "normal tinnitus" in a completely quiet room; but it is of concern only if it is bothersome, interferes with normal hearing, or is associated with other problems. While often described as a ringing, it may also sound like a clicking, buzzing, hissing or roaring. It may be soft or loud, low- or high- pitched, and may seem to come from one or both ears or from the head itself. In some people, it may interfere with concentration, and in some cases is associated with anxiety and depression. Tinnitus is usually associated with a degree of hearing loss and decreased comprehension of speech in noisy environments. It is common, affecting about 10–15% of people. Most, however, tolerate it well, and it is a significant problem in only 1–2% of all people. It can trigger a fight-or-flight response, as the brain may perceive it as dangerous and important. The word ' ...
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Mastoidectomy
A mastoidectomy is a procedure performed to remove the mastoid air cells, air bubbles in the skull, near the inner ears. This can be done as part of treatment for mastoiditis, chronic suppurative otitis media or cholesteatoma. In addition, it is sometimes performed as part of other procedures (cochlear implant) or for access to the middle ear. There are classically 5 different types of mastoidectomy: ;* Radical : Removal of posterior and superior canal wall, meatoplasty and exteriorisation of middle ear. ;* Canal wall down : Removal of posterior and superior canal wall, meatoplasty. Tympanic membrane left in place. ;* Canal wall up : Posterior and superior canal wall are kept intact. A facial recess approach is taken. ;* Cortical : (Also known as schwartze procedure) - Removal of Mastoid air cells is undertaken without affecting the middle ear. This is typically done for mastoiditis Mastoiditis is the result of an infection that extends to the air cells of the skull behind the e ...
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Stapedectomy
A stapedectomy is a surgical procedure of the middle ear performed in order to improve hearing. If the stapes footplate is fixed in position, rather than being normally mobile, the result is a conductive hearing loss. There are two major causes of stapes fixation. The first is a disease process of abnormal mineralization of the temporal bone called otosclerosis. The second is a congenital malformation of the stapes. In both of these situations, it is possible to improve hearing by removing the stapes bone and replacing it with a micro prosthesis - a stapedectomy, or creating a fenestra, small hole in the fixed stapes footplate and inserting a tiny, piston-like prosthesis - a stapedotomy. The results of this surgery are generally most reliable in patients whose stapes has lost mobility because of otosclerosis. Nine out of ten patients who undergo the procedure will come out with significantly improved hearing while less than 1% will experience worsened hearing acuity or deafness. Su ...
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Audiology
Audiology (from Latin , "to hear"; and from Greek , ''-logia'') is a branch of science that studies hearing, balance, and related disorders. Audiologists treat those with hearing loss and proactively prevent related damage. By employing various testing strategies (e.g. behavioral hearing tests, otoacoustic emission measurements, and electrophysiologic tests), audiologists aim to determine whether someone has normal sensitivity to sounds. If hearing loss is identified, audiologists determine which portions of hearing (high, middle, or low frequencies) are affected, to what degree (severity of loss), and where the lesion causing the hearing loss is found (outer ear, middle ear, inner ear, auditory nerve and/or central nervous system). If an audiologist determines that a hearing loss or vestibular abnormality is present, they will provide recommendations for interventions or rehabilitation (e.g. hearing aids, cochlear implants, appropriate medical referrals). In addition to diagn ...
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Tympanoplasty
Tympanoplasty is the surgical operation performed to reconstruct hearing mechanism of middle ear Classification Tympanoplasty is classified into five different types, originally described by Horst Ludwig Wullstein (1906–1987) in 1956. # Type 1 involves repair of the tympanic membrane alone, when the middle ear is normal. A type 1 tympanoplasty is synonymous to myringoplasty. # Type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles. # Type 3 involves removal of ossicles and epitympanum when there are large defects of the malleus and incus. The tympanic membrane is repaired and directly connected to the head of the stapes. # Type 4 describes a repair when the stapes foot plate is movable, but the crura are missing. The resulting middle ear will only consist of the Eustachian tube and hypotympanum. # Type 5 is a repair involving a fixed stapes footplate. Also called fenestration operation. Myringoplasty The term 'myring ...
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