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 Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the specialty (medicine), medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system ...

. Otology may refer to ENT

physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...

s 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 The University of Maryland Medical Center (UMMC) is a teaching hospital with 789 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 inp ...

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, 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) is a type of hearing impairment that occurs when sound waves are unable to efficiently travel through the outer ear, tympanic membrane (eardrum), or middle ear structures such as the ossicles. This blockage or dysfun ...

by reconstructing the hearing bones, or

ossicles The ossicles (also called auditory ossicles) are three irregular bones in the middle ear of humans and other mammals, and are among the smallest bones in the human body. Although the term "ossicle" literally means "tiny bone" (from Latin ''ossi ...

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

otosclerosis Otosclerosis is a condition of the middle ear, middle and inner ear where portions of the dense enchondral layer of the bony labyrinth Tissue remodeling, remodel into one or more lesions of irregularly-laid spongy bone. As the lesions reach the s ...

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

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, surgery of the endolymphatic sac 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 in ...

and

cochlear implant A cochlear implant (CI) is a surgically implanted Neuroprosthetics, 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 imp ...

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 subspecialty within medicine that deals with the surgical an ...

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.

Conditions

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

and vestibular neuronitis * 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 ...

(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 facia ...

* 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 Anatomical terms of location#Superior and inferior, inferior area of the human skull, skull. It is composed of the endocranium and the lower parts of the Calvaria ...

References

{{Neuroscience Clinical neuroscience Otology Otorhinolaryngology

Education and training

Conditions

See also

References