otologyneurotology

Otologyneurotology, often simply called neurotology or otoneurology, is a medical subspecialty within otolaryngology that integrates otology and neurology to diagnose and treat disorders of the ear and the neural pathways involved in hearing and balance. The field encompasses diseases of the inner ear, auditory nerve, and skull base structures that affect hearing and equilibrium.

Key focus areas include sensorineural hearing loss, vestibular disorders, Ménière’s disease, vestibular schwannoma (acoustic neuroma), auditory neuropathy, and other complex ear and nerve disorders that require combined medical and surgical management.

Diagnostic approaches combine detailed medical history with audiology (including pure-tone and speech testing), vestibular testing, and advanced imaging such as magnetic resonance imaging (MRI) and computed tomography (CT). Electrophysiological tests and genetic assessments may also be used.

Treatment strategies include medical therapy (for example steroids for sudden hearing loss or autoimmune inner ear disease), rehabilitation (audiologic rehabilitation and vestibular rehabilitation), and surgical interventions. Procedures may involve stapedectomy or stapedotomy for conductive loss, cochlear implantation for severe sensorineural loss, and skull base or tumor surgery (such as vestibular schwannoma resection) when indicated.

Training and scope: most practitioners complete residency in otolaryngology followed by a fellowship in neurotology or otoneurology, gaining expertise in skull base techniques, implantable devices, and complex diagnostics. The specialty emphasizes multidisciplinary collaboration with neurology, neurosurgery, radiology, and physical therapy to restore hearing, balance, and neural function.