Why You May Need to See a Neurotologist for Ear‑Related Issues
Why You May Need to See a Neurotologist for Ear‑Related Issues
If you’re experiencing ongoing or complex problems with your ears, you may be referred to a neurotologist. A neurotologist is a board-certified ear, nose, and throat (ENT) specialist who completed two more years of training focusing on the “E” (ears) in ENT. That means that they diagnose and treat patients with complex conditions affecting the ear, including hearing loss, chronic ear infections, and tumors of the ear and skull base.
Richard K. Gurgel, MD, MSCI, a neurotologist at University of Utah Health, describes some of the most common conditions neurotologists treat and how they help patients improve or restore hearing.
Do Most Patients See Other Specialists Before a Neurotologist?
At University of Utah Health, most patients are first evaluated by a general ENT specialist, who then refers them to neurotology for sub-specialized care. You might be referred to a neurotologist if:
- You’re experiencing hearing loss
- Your hearing aids are no longer working
- You notice hearing loss in only one ear
- You have ongoing drainage and infections from the ear
What Conditions Does a Neurotologist Treat?
Neurotologists address issues that affect any part of the hearing pathway—including the ear canal, eardrum, the three little bones that attach to the eardrum, the inner ear, and the nerves that connect the ear to the brain.
Common conditions include:
- Ear bone problems: The bones that attach to the eardrum can become disconnected or stuck in place. They can be replaced or surgically repaired to help restore heating.
- Tumors on the hearing or balance nerve: Tumors on these areas can cause hearing loss. At U of U Health, neurotologists work closely with neurosurgeons to perform combined skull-based surgeries and work around those nerves to prevent hearing loss.
- Facial nerve disorders: The nerve responsible for facial movement runs in a complex course through the ear. Damage to this nerve can result in facial weakness, almost like a stroke.
How Are Balance Issues Connected To the Ear?
The inner ear helps the body with both hearing and balance. Patients might experience balance issues and dizziness with or without hearing loss. The inner ear plays an important role in balance, like a compass for the head—sending balance information to your brain when your head turns. But your vision, musculoskeletal system, and brain all play a role in balance, not just the ears.
“At U and U Health, that’s why we always try to determine the cause of the imbalance,” Gurgel says. “If it’s an ear issue, then we would treat those patients.”
How Do Neurotologists Treat Ringing in the Ears (Tinnitus)?
Tinnitus affects about 15–20% of Americans, and it’s a challenging condition to treat.
“For any patrient with tinnitus, we provide a comprehensive head and neck and ear exam, review the whole history of symptoms, and conduct a hearing test,” Gurgel says.
If a patient has tinnitus with or without hearing loss, imaging may be needed for an accurate diagnosis. A microscope can be used that captures a detailed view of the ear, including the eardrum, signs of infection or inflammation, and all the nerves of the head and neck.
What Is the Most Common Condition Neurotologists Treat?
Hearing loss is by far the most common condition, according to Gurgel.
“For severe hearing loss, in which a hearing aid is no longer helpful, we may offer a cochlear implant,” Gurgel says.
A cochlear implant is an electrical device that stimulates the cochlear nerve to restore hearing. Cochlear impacts can be used by any patient of all ages, including infants born deaf and older adults who have lost their hearing later in life.
“The implants work incredibly well and are one of the greatest advances in modern medicine we’ve seen,” Gurgel says. “That’s because we can restore a lost neurological sensation with hearing and bring that back to someone’s life.”
There are other non-hearing-related consequences to hearing loss like depression, anxiety, social isolation, falls, and cognitive decline. Neurotologists at U of U Health can help prevent all of those by treating hearing loss.
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