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Anatomy of the Temporal Bone, External Ear, and Middle Ear
The temporal bone is a paired bone forming part of the lateral skull base, housing the organs of hearing and balance, the facial nerve, and the internal carotid artery Composed …
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Otology / Neurotology
Board-review topics in Otology / Neurotology.
52 topics
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Anatomy of the Vestibular System
The peripheral vestibular system consists of five end organs within the bony labyrinth: three semicircular canals (detecting angular acceleration) and two otolith organs (detect…
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Auditory Brainstem Implantation
Auditory brainstem implant (ABI) is a neuroprosthesis that directly stimulates the cochlear nucleus complex on the brainstem surface to provide auditory input Bypasses both the …
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Autoimmune Inner Ear Disease
Autoimmune inner ear disease (AIED) is an immune-mediated sensorineural hearing loss characterized by bilateral, progressive, fluctuating SNHL that responds to immunosuppressive…
Canalplasty for Exostosis
Exostoses are benign, broad-based, pedunculated or sessile bony growths arising from the bony external auditory canal (EAC), typically bilateral and multiple Canalplasty is the …
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Cholesteatoma
A cholesteatoma is a destructive, expansile collection of keratinizing stratified squamous epithelium within the middle ear or mastoid that is not normally lined by squamous epi…
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Chronic Otitis Media, Mastoiditis, and Cholesteatoma
Chronic otitis media (COM): persistent inflammatory disease of the middle ear and mastoid with irreversible mucosal changes, with or without tympanic membrane (TM) perforation C…
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Clinical Assessment and Treatment of Conductive Hearing Loss
Conductive hearing loss (CHL) results from impaired sound transmission through the external ear, tympanic membrane, or middle ear ossicular chain to the oval window Characterize…
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Clinical Disorders of the Facial Nerve
Facial nerve (CN VII) disorders encompass a spectrum of conditions causing facial paralysis or paresis, ranging from idiopathic to infectious, neoplastic, traumatic, congenital,…
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Cochlear Implantation
Cochlear implants (CIs) are auditory prostheses that convert acoustic information into electrical stimulation of the auditory nerve, bypassing dysfunctional or absent cochlear h…
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Cochlear Transduction and Molecular Basis of Auditory Pathology
Cochlear transduction is the mechanoelectrical process by which sound energy is converted to neural impulses in the cochlea Involves the organ of Corti, basilar membrane mechani…
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Complications of Temporal Bone Infections
Complications of otitis media and mastoiditis that extend beyond the confines of the middle ear and mastoid air cell system Classified as intratemporal (within the temporal bone…
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Cortical Neuroplasticity in Hearing Loss
Cortical neuroplasticity refers to the brain's ability to reorganize neural pathways and cortical representations in response to altered sensory input, including hearing loss In…
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Eustachian Tube Anatomy and Physiology
The eustachian tube (ET) (pharyngotympanic tube/auditory tube) is a 31-38 mm conduit connecting the middle ear to the nasopharynx Functions: pressure equalization (ventilation),…
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Excision of Preauricular Pits and Sinuses
Preauricular pits (sinuses) are congenital blind-ending tracts located anterior to the ascending helix of the auricle, representing incomplete fusion of the hillocks of His duri…
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External Ear Infections and Otitis Externa
Otitis externa (OE) represents infection or inflammation of the external auditory canal (EAC) Ranges in severity from mild canal inflammation to life-threatening skull base oste…
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Facial Nerve Disorders and Bell's Palsy
Facial nerve (CN VII) is a mixed motor-sensory nerve composed of approximately 6000 axons Bell palsy is an acute idiopathic peripheral facial paralysis; the most common cause of…
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Genetic Sensorineural Hearing Loss
Genetic hearing loss accounts for approximately 50-60% of congenital hearing loss in developed countries Classified as nonsyndromic (70-80%) or syndromic (20-30%) Nonsyndromic f…
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Genetics of Ear Disorders
Genetic hearing loss accounts for approximately 50–60% of congenital hearing loss in developed countries Classified as syndromic (~30%) or nonsyndromic (~70%) hereditary hearing…
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Geriatric Otology
Geriatric otology addresses age-related changes in auditory and vestibular function, focusing on presbycusis, central auditory processing decline, and balance disorders in patie…
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Implantable Hearing Devices
Implantable hearing devices are surgically placed prostheses that improve hearing by directly stimulating the ossicular chain, temporal bone, cochlea, or auditory nerve Categori…
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Infections of the Labyrinth
Labyrinthitis is inflammation of the membranous labyrinth (cochlear and vestibular portions) due to infectious agents or their toxins Classified by route of entry: tympanogenic …
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Interventional Neuroradiology of the Skull Base
Interventional neuroradiology (INR) encompasses endovascular and percutaneous image-guided procedures for the diagnosis and treatment of vascular and neoplastic conditions of th…
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Intraoperative Monitoring of Cranial Nerves
Intraoperative cranial nerve monitoring (ICNM) is the real-time electrophysiologic assessment of cranial nerve function during surgery to minimize iatrogenic nerve injury Most c…
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Intratemporal Facial Nerve Surgery
Intratemporal facial nerve surgery encompasses decompression, repair, and grafting of the facial nerve within the temporal bone Indications include Bell palsy (severe), temporal…
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Mastoidectomy
Mastoidectomy is the surgical removal of mastoid air cells to treat disease, provide access to middle ear and epitympanum, or create a safe, dry ear Types: cortical (simple), ca…
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Meatoplasty
Meatoplasty is the surgical enlargement of the external auditory meatus (EAM) and/or cartilaginous ear canal to create a wider opening for aeration, drainage, and access to the …
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Middle Ear Endoscopic Surgery
Endoscopic ear surgery (EES) refers to transcanal middle ear procedures performed exclusively or primarily with rigid endoscopes, replacing or supplementing the binocular micros…
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Neoplasms of the Posterior Fossa
Posterior fossa neoplasms relevant to otolaryngology include tumors of the cerebellopontine angle (CPA), IAC, jugular foramen, and posterior temporal bone Vestibular schwannoma …
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Neuroanatomy of the Auditory System
The central auditory pathway extends from the cochlear nucleus in the brainstem to the primary auditory cortex in the temporal lobe Composed of multiple relay stations with both…
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Neuroradiology of the Temporal Bone and Skull Base
Imaging of the temporal bone and skull base is essential for diagnosis, surgical planning, and postoperative surveillance in otologic and lateral skull base disease High-resolut…
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Noise-Induced Hearing Loss
Noise-induced hearing loss (NIHL) is sensorineural hearing loss caused by exposure to hazardous noise levels, resulting in irreversible damage to cochlear structures Affects app…
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Otologic Manifestations of Systemic Disease
Numerous systemic diseases produce otologic manifestations including hearing loss, vertigo, tinnitus, and structural changes of the temporal bone Otologic findings may be the in…
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Otologic Symptoms and Syndromes
This card covers the major named otologic syndromes and the differential diagnosis approach to common otologic symptoms (otalgia, otorrhea, tinnitus, hearing loss, vertigo, and …
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Otosclerosis
Disease of endochondral bone remodeling unique to the otic capsule Characterized by disordered osteoclastic resorption (otospongiosis/active phase) followed by new osteoblastic …
Pharmacologic and Molecular Therapies of the Cochlear and Vestibular Labyrinths
Emerging field targeting the inner ear with local or systemic pharmacologic and molecular agents to treat or prevent SNHL, vestibular disorders, and tinnitus Intratympanic (IT) …
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Physiology of the Auditory System
Auditory physiology encompasses the mechanisms by which sound energy is collected, transmitted, transduced into neural signals, and encoded for central processing The system ope…
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Radiation Therapy of Benign Tumors of the Cranial Base
Stereotactic radiosurgery (SRS) delivers a single, highly focused, high-dose radiation fraction to a precisely defined intracranial target using rigid immobilization and 3D imag…
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Rehabilitation of Facial Paralysis
Facial paralysis rehabilitation encompasses surgical and non-surgical techniques to restore facial symmetry, movement, and function after irreversible facial nerve injury Indica…
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Sensorineural Hearing Loss and Sudden SNHL
Sensorineural hearing loss (SNHL): hearing loss resulting from cochlear hair cell dysfunction, auditory nerve dysfunction, or central auditory pathway pathology Sudden SNHL (NID…
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Sensorineural Hearing Loss in Adults
Sensorineural hearing loss (SNHL) results from pathology of the cochlea (sensory) or auditory nerve (neural); air and bone conduction thresholds are equally reduced with no air-…
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Surgery of the Anterior and Middle Cranial Base
Anterior cranial base (ACB) surgery: resection of tumors involving the floor of the anterior cranial fossa (cribriform plate, planum sphenoidale, orbital roof, posterior table o…
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Surgical Anatomy of the Lateral Skull Base
The lateral skull base encompasses the temporal bone and adjacent structures forming the floor of the middle cranial fossa and the posterior fossa boundary lateral to the brains…
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Surgical Management of Auricular Cutaneous Malignancy
Auricular cutaneous malignancy encompasses primary skin cancers arising on the pinna and periauricular skin, most commonly basal cell carcinoma (BCC), squamous cell carcinoma (S…
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Temporal Bone Neoplasms and Lateral Cranial Base Surgery
Temporal bone neoplasms are rare malignancies (incidence: 1–6 per million per year) and benign tumors arising from or involving the temporal bone Squamous cell carcinoma (SCC) i…
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Temporal Bone Trauma
Fracture of the temporal bone resulting from high-energy trauma to the skull base Requires approximately 1875 pounds of lateral force to fracture in cadaveric studies Associated…
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Tests of Facial Nerve Function
Facial nerve testing encompasses clinical assessment scales and electrodiagnostic studies used to evaluate the degree and prognosis of facial nerve injury Testing guides managem…
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Tinnitus and Hyperacusis
Tinnitus: perception of sound in the absence of an external acoustic stimulus; affects 10–15% of adults, bothersome in 1–2% Subjective tinnitus: perceived only by patient (vast …
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Topical Therapies of External Ear Disorders
Topical otic therapy is the first-line treatment for most external ear disorders, delivering high drug concentrations directly to the site of disease with minimal systemic absor…
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Tympanoplasty and Ossiculoplasty
Tympanoplasty: surgical procedure to eradicate middle ear infection and restore function of the middle ear; includes TM reconstruction ± ossicular chain reconstruction Ossiculop…
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Vestibular and Auditory Ototoxicity
Ototoxicity refers to drug-induced damage to the cochlea (auditory) and/or vestibular end organs, resulting in hearing loss, tinnitus, and/or vestibular dysfunction Over 200 med…
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Vestibular Schwannoma (Acoustic Neuroma)
Vestibular schwannoma (VS, acoustic neuroma) is a benign schwannoma arising from Schwann cells of the vestibular division of the 8th cranial nerve Accounts for 8–10% of all intr…