Neurology diagnoses and treats disorders of the nervous system, including the brain, spinal cord, and nerves, as well as thought and memory.
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Neurotology is a specialized medical field that focuses on the connection between your ear and your brain. It goes beyond the outer and middle ear to treat the nerve pathways, the side of your skull base, and the sensory organs responsible for hearing and balance. This field requires expertise in both delicate microsurgery and nerve-related diagnosis to treat conditions located deep within the temporal bone (the bone around your ear) and the skull.
Neurotology focuses on the lateral skull base, which is an area with thick bone and important nerves and blood vessels. This area contains the nerves that control your hearing, balance, and facial movements. The vestibulocochlear nerve is the main nerve involved, carrying signals from your inner ear to your brainstem.
Understanding the layout of this region is essential for safe treatment. The temporal bone contains the cochlea and vestibular system, but it also sits next to the carotid artery and the jugular bulb. Neurotologists must work with extreme precision to reach problem areas without causing damage to the brain or blood supply.
Neurotology treats many different conditions that affect how your ear and brain work together. This includes noncancerous tumors such as vestibular schwannomas, which grow on the balance nerve. It also includes other tumors like meningiomas and vascular tumors such as glomus jugulare. The field also treats metabolic and autoimmune disorders that disrupt the fluid balance of the inner ear.
Beyond tumors, neurotology also treats complex balance disorders that have a central or mixed cause. Conditions like Meniere’s disease, superior semicircular canal dehiscence, and vestibular migraines fall under this category. The goal is to restore the patient’s ability to interact with their environment by improving their balance and hearing.
Due to the location of these disorders near the brainstem, neurotology is inherently collaborative. It represents a fusion of otolaryngology and neurosurgery. Complex skull base surgeries are often performed by a dual surgeon team, allowing for the removal of tumors while maximizing the preservation of neural function.
This team approach ensures that every aspect of your health is considered. From preserving your ability to move your face to maintaining your hearing, the care team balances the goal of removing disease with maintaining your quality of life. Regular meetings and case reviews are standard practice to determine the best treatment path for you.
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Otology generally focuses on the ear canal, eardrum, and middle ear bones. Neurotology focuses on the inner ear, the hearing and balance nerves, and the skull base where the ear connects to the brain.
Neurotologists operate on the skull base and the areas surrounding the brainstem. They often work alongside neurosurgeons to treat tumors and conditions that affect the connection between the ear and the brain.
The cerebellopontine angle is a specific space in the skull base. It is located between the cerebellum and the pons of the brainstem. Acoustic neuromas and other neurotologic tumors frequently occur in this area.
Typically, patients are referred to a neurotologist by general ENT doctors, neurologists, or primary care physicians after initial testing suggests a complex inner ear or skull base issue.
Yes. Because the facial nerve runs directly through the ear and skull base, neurotologists are experts in diagnosing, decompressing, and repairing the facial nerve.
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