Vertigo, dizziness, deafness, tinnitus, balance disorders

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Otoneurology is a subspecialty focusing on conditions affecting the inner ear and facial nerve. The inner ear plays an essential role in our hearing (via the cochlea and central auditory pathways) and balance (via the central and peripheral vestibular system).

All disorders result in hearing loss, either by transmission (middle ear condition), or by perception, and tinnitus (inner ear condition). The specific cause is diagnosed by way of different tests (pure tone and speech audiometry, evoked response audiometry) and sometimes imaging (scan of the petrous part of the temporal bone, cerebral MRI focusing on internal ear canals). Diagnosing the causal condition is essential to choosing the most suitable treatment, which may be either surgical or medical.

This system plays a part in our balance reactions (via the vestibulospinal reflexes) and in how our image of the visual world is stabilised on the retina (via the vestibuloocular reflexes). Any unilateral condition is characterised by the onset of rotary vertigo, nausea, and even vomiting and a feeling of unsteadiness. Dizziness is common and disabling, and can stem from a peripheral disease such as vestibular hydrops, Meniere’s disease, vestibular neuritis or benign positional vertigo when otoconia are dislodged into one of the semicircular canals. The cause of dizziness and unsteadiness is assessed by way of in-depth examinations (videonystagmograph, vestibular evoked myogenic potential, EquiTest) to initiate effective treatment.

The facial nerve controls motricity in our face. It can be the seat of benign tumours, demyelination or viral infections. Any partial or complete facial paralysis requires rapid treatment after electrophysiological examination.