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 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 ...

clinical neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...

and

neurosurgery Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peri ...

. Otology may refer to ENT

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

s who "...

tudy Tudy may refer to: People * Tudy of Landevennec, Breton saint Places * Île-Tudy, France * St Tudy St Tudy ( kw, Eglostudi) is a civil parish and village in north Cornwall, England, United Kingdom. The village is situated in the River Camel ...

normal 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 The University of Maryland Medical Center (UMMC) is a teaching hospital with 806 beds based in Baltimore, Maryland, that provides the full range of health care to people throughout Maryland and the Mid-Atlantic region. It gets more than 26,000 inpa ...

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 as a

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 ...

, or a reconstruction of the eardrum, when a hole remains from a prior ear tube or infection. Otologic surgery includes treatment of

conductive hearing loss Conductive hearing loss (CHL) occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, tympanic membrane (eardrum), or middle ear ( ossicles). If a conductive hearing loss occurs in conjunction wi ...

by reconstructing the hearing bones, or

ossicles The ossicles (also called auditory ossicles) are three bones in either middle ear that are among the smallest bones in the human body. They serve to transmit sounds from the air to the fluid-filled labyrinth (cochlea). The absence of the auditory ...

, as a result of infection, or by replacing the stapes bone with a

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 ...

for

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 hardene ...

. Otology and neurotology encompass more complex surgery of the inner ear not typically performed by general otolaryngologists, such as removal of complex

cholesteatoma Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Cholesteatomas are not cancerous as the name may suggest, but can cause significant problems because of the ...

labyrinthectomy A labyrinthectomy is a procedure used to decrease the function of the labyrinth of the inner ear. This can be done surgically or chemically. It may be done to treat Ménière's disease Ménière's disease (MD) is a disease of the inner ear tha ...

, surgery of the

endolymphatic sac From the posterior wall of the saccule a canal, the endolymphatic duct, is given off; this duct is joined by the utriculosaccular duct, and then passes along the vestibular aqueduct and ends in a blind pouch, the endolymphatic sac, on the posteri ...

for

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 initial ...

and

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 und ...

surgery.

Education and training

It is more and more common in the United States as well as around the world for

otolaryngologist 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 a ...

s to obtain additional advanced training in neurotology, which requires an additional one or two years of fellowship training after the usual five years of

residency Residency may refer to: * Domicile (law), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship * Residency (medicine), a stage of postgrad ...

Conditions

Conditions treated by neurotologists include: * Vestibular (balance) diseases, such as

and

vestibular neuronitis Labyrinthitis is inflammation of the labyrinth – a maze of fluid-filled channels in the inner ear. Vestibular neuritis is inflammation of the vestibular nerve – the nerve in the inner ear that sends messages related to motion and position t ...

* Skull base

tumors A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

, such as

vestibular schwannoma 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 o ...

(acoustic neuroma) * Facial nerve disorders, including

facial nerve paralysis Facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. The pathway of the facial nerve is long and relatively convoluted, so there are a number of causes that may result in facial ...

* Hearing loss and deafness * Certain conditions relating to the

skull base The base of skull, also known as the cranial base or the cranial floor, is the most inferior area of the skull. It is composed of the endocranium and the lower parts of the calvaria. Structure Structures found at the base of the skull are for ...

References

{{Authority control Clinical neuroscience Otology Otorhinolaryngology

Education and training

Conditions

See also

References