The otology and neurotology service is comprised of physicians who specialize in the care of chronic ear disease, hearing loss, dizziness, tinnitus, and facial nerve disorders. Otologic diagnostic services at New York Eye and Ear Infirmary of Mount Sinai include standard audiometry (pure tone and bone), speech audiometry, and impedance testing. In addition, auditory brainstem reflex (ABR) testing, otoacoustic emission testing and ultra-high frequency testing and tests of central auditory perception are available as necessary. Electrocochleography, an evoked response produced by the cochlea, is also available.
Hearing Restoration Surgery
Certain forms of hearing loss are caused by the blockage of sound along its pathway to the inner ear. This causes a conductive hearing loss. Depending upon the cause, some forms of conductive hearing loss can be surgically corrected. A complete examination by the otologist with a professional audiogram will identify these conditions.
One example of such a restorable loss of hearing is otosclerosis which is caused by a progressive fixation of the stapes (stirrup) bone. The conductive component of the hearing loss may be restored by a procedure called a stapedectomy. The otologist would be able to diagnose this condition in most instances and to suggest an approach for its remedy.
Another example is conductive hearing loss due to chronic ear disease and/or cholesteatoma. In general, the primary goal of surgery is to obtain a safe, dry ear which does not discharge. Once this has been achieved, the goal of surgery is toward a well-hearing ear. It is more difficult to obtain a well-hearing ear in these two conditions than with otosclerosis.
Any patient who is a surgical candidate for surgical hearing restoration is by definition a candidate as well for a hearing aid. The fidelity of hearing is in general better with surgery than with a hearing aid. This should be discussed with the otologist who will recommend either surgery or amplification for each specific case.
A full diagnostic vestibular laboratory including electronystagmography, platform posturography and rotational chair testing are available at New York Eye and Ear Infirmary. Patients with dizziness or vertigo are evaluated as necessary with these modalities. Patients with chronic dizziness who require vestibular rehabilitation are referred for vestibular therapy. The service performs approximately ten times the national average of stapedectomies on a yearly basis, using both standard and laser techniques.
Children and adults with congenital auricular atresia, or microtia, are cared for here by the Microtia Service, comprised of a team of surgeons from the disciplines of Facial Plastic and Reconstructive Surgery, Oral and Maxillofacial Surgery, and Otology. All clinical, radiological, surgical and post-operative care for these patients is provided here at New York Eye and Ear Infirmary.
Otology / Neurotology Clinic
Patients with asymmetrical neurosensory hearing loss, tinnitus or dizziness are eventually referred to the Otology/Neurotology clinic. The clinical history and pertinent physical findings are presented to the attending physicians. The differential and specific diagnoses are discussed and both the investigational and treatment programs are formulated.
Patients with disorders of the facial nerve are seen in the Otology/Neurotology Clinic. These patients receive urgent rehabilitation of the nonfunctioning eyelid and the diagnostic plan is started. This usually consists of an audiogram, ENOG for complete clinical paralysis, ENG and a retrocochlear examination (ABR or MRI) in selected cases. Surgical decompression, if necessary, is planned by the chief resident on the Otology/Neurotology service. Otology, Neurotology and Skull Base Surgery is one of the busiest services at New York Eye and Ear Infirmary.