Otology and Neurotology are related fields of study within otolaryngology. Otologic surgery is a very technical skill that requires significant training. It generally refers to middle ear and mastoid surgery, including stapedectomy, ossicular reconstruction, stapedectomy and cholesteatoma surgery.
Neurotology generally refers to treatment of the neurologic conditions of the ear. Inner ear surgeries that treat these conditions, and that have a greater risk to the hearing and balance organs deserve a distinction, and are generally referred to as neurotologic surgery. This includes labyrinthectomy, cochlear implantation, endolymphatic sac enhancement surgery and surgery for removal of tumors of the temporal bone, including glomus tympanicum, intracanalicular acoustic neuromas, and other less common tumors. Tumors originating in the ear often extend beyond the temporal bone to the lateral skull base, and require intracranial surgery for complete resection.
Many otologic and neurotologic surgeries fall within the scope and board certification of general otolaryngology – head and neck surgery, and many residency programs provide excellent training in ear surgery. However, these cases can be very challenging and do require a large and consistent case load to remain proficient while in practice, and to be able to manage otologic complications. To provide the full range of services in otology, neurotology and lateral skull base surgery, otolaryngology graduates should obtain advanced training in a fellowship program.
Advanced otologic surgical training during an additional year of fellowship can be very beneficial to an otolaryngologist who is wanting to emphasize otology in their practice, to improve their surgical skills, and increase confidence in referring physicians within and from without their practice. In order to become proficient in neurotologic surgeries, such as cochlear implantation, otolaryngology graduates should complete additional training. Completing an advanced otology fellowship can also improve on skills to treat medical neurotology, giving one confidence to treat conditions such as Meniere’s disease and vestibular migraine. Many of these programs also offer experience with skull base surgeries, such as for acoustic neuromas or glomus tumors. Each advanced otology fellowship provides a certificate of completion, which together with the surgical case log, can help with getting hospital credentials for neurotologic surgery. See our Advanced Otology Fellowships.
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Two-year accredited fellowship programs are typically geared towards research and suitable for someone wanting to pursue academics and be eligible for board-certification in neurotology and skull base surgery. If you are interested in finding out more information about two-year accredited programs, visit the San Francisco Matching Program website.