Otology/Neurotology

Otology, neurotology, and lateral skull base surgery is a subspecialty of otolaryngology (ENT) primarily focusing on disorders of the temporal bone (the bone that hosts the ear) and adjacent structures such as the brainstem and cerebellum. As such, a neurotologist typically manages problems of the hearing and balance systems.

However, the field has evolved changed quite dramatically over the past century. Specifically, in the early days about one century ago, the practice of otology was primarily concerned with drainage of infection of the ear and temporal bone as a means of preventing life-threatening complications. With the advent of tympanoplasty techniques and later the fenestration procedure and stapedectomy, surgical restoration of hearing loss became possible. In the last half of the 20th century, William House and others established the transtemporal approaches to the internal auditory canal and cerebellopontine angle as well as the cochlear implant and facial nerve monitor, thereby providing the foundation for the field of neurotology and lateral skull base surgery. As recently as the last decade, new diseases and therapeutic concepts continue to evolve such as the superior canal dehiscence syndrome. Today, advances in biomedical engineering and molecular biology hold the keys to the next generation of advances that are already visible on the horizon. Interventions that were once considered somewhat esoteric by some might now be considered part of the medical mainstream. Cochlear implantation is certainly an example of such an intervention, which continues to expand our field.