Neurotology: what is it and what disorders does it treat?

A new specialty of medicine related to neurology and otorhinolaryngology.

The human body is an organism made up of a large number of systems, whose coordinated management allows us to function correctly and to be able to survive and adapt to the environment. Among them we can find the nervous system, thanks to which the aforementioned coordination and management is possible, or systems as relevant as the auditory system, which in addition to the perception of sounds itself also has an effect on our orientation, balance and postural maintenance.

However, there are several problems that can appear in these systems, which can have a significant impact on our quality of life. Fortunately, there are medical specialties focused on the relationship between the nervous system and the auditory-vestibular system that make it possible to detect and treat the different disorders and problems that may arise, highlighting the relatively recent neurotology.

What is neurotology?

It is understood by neurotology or otoneurology is one of the branches of the medicine which specializes in the study of the relations between the auditory system and the nervous system. It is considered a sub-specialization of the specialty of otorhinolaryngology, since most of the time we are dealingIt is considered a subspecialty of the specialty of otorhinolaryngology, since most of the problems originate in or affect the inner ear. However, it could also be a very specific subspecialty of neurology, since it is the connection with the nervous system that is explored.

Thus, neurotology is mainly responsible for the investigation, diagnosis and treatment of disorders in which there is an alteration in the interaction between the two systems. More specifically, the study of the human body from this sub-specialization of medicine focuses on the inner ear, the vestibular system, the skull, and the facial, auditory, vestibular, vagus, spinal, lower and hypoglossal nerves, among others.

These specialists usually perform both otological and neurological evaluations to define and find the causes of to define and find the causes of disorders related to dizziness, floating sensations and hearing loss. In general, these are hearing problems and problems related to balance or body position resulting from neurological involvement.

Necessary training

This medical field already possessed a strong body of theoretical knowledge since the 20th century, but it was not until a few decades ago that it was established as a subspecialty. To become a neuro-otologist or otoneurologist we must have knowledge of both otolaryngology and neurology.

To achieve this title it will be necessary first to have studied medicine, after which it is necessary to specialize in otorhinolaryngology (although the possibility of arriving from neurology is not ruled out) and then sub-specialize in this field. This is a long and a prolonged and very exhaustive type of training in a very specific part of the organism..

Although it is already a sub-specialization within neurotology, there is also a more specific sub-branch: otoneurosurgery. It is possible that it may be necessary to perform some type of surgical intervention, requiring a great deal of preparation for it.

Problems and diseases usually encountered

Neurotology is a medical discipline that deals with very diverse problems that can generate different levels of affectation and functional limitation to the people who suffer from them, in some cases even endangering their lives. Within the group of these disorders, the following stand out.

1. Hearing loss and deafness

We call hypoacusis a loss of hearing ability that, although it is not total, supposes a loss of the functionality and the capacity of the person in his day to day. Deafness as such would be the total loss of hearing capacity.

In both cases we are facing something distressing and that generates limitations in daily life, whose causes should be carefully analyzed. An example of a disease that generates hypoacusis is otosclerosis. Likewise, probably one of the best known types of intervention performed by neurotology in this sense is the cochlear implant.

2. Vertigo

Probably one of the problems most frequently seen by neurotologists is vertigo. Vertigo is understood as a symptom (since it is not a disorder in itself but would be indicating some type of affectation or alteration of the vestibular system) characterized by the presence of dizziness, balance and orientation problemsThe symptoms are characterized by the presence of dizziness, balance and orientation problems, discomfort, sensation that the world is around us or even fainting.

3. Tinnitus and tinnitus

The frequent perception of ringing or buzzing sounds coming from the ear that often make hearing difficult is often a reason for consultation, which neurologists can examine to determine their causes.

4. Ménière's disease

Ménière's disease is a disorder characterized by balance and hearing problems which are caused by alterations in the labyrinth. It usually causes dizziness, tinnitus (continuous roaring noises) and sensations of discomfort, and the subject may become deaf. The specific causes are still unknown and there is no cure as such, but it can be treated in such a way that it is controlled.

5. Facial paralysis

Although somewhat different from the previous ones, it is possible to meet with people who suffer some type of facial paralysis associated with the lesion or pinching of some of the cranial pairs.nerves that are also studied from neurotology.

6. Tumors

It is also possible that different types of tumors of different degrees appear in the auditory pathways or in the nerves that connect these with the brain, or that some type of tumor presses the nervous pathways of these areas. Neurotology can also contribute to the detection of these neoplasms. An example is the acoustic neurinoma.

7. Malformations

In addition to the above, we can also find the presence of different types of malformations, both congenital and acquired (for example, as a result of accidents).

By means of neurotheology it is possible to observe the level of affectation of the auditory and vestibular systems and even correct by surgery some affectations and malformations that hinder their proper functioning.

Bibliographic references

• Carmona, S. (2015). Current otoneurology. An Iberoamerican perspective. Mexican Journal of Communication, Audiology, Otoneurology and Phoniatrics, 4 (1).