Aural atresia usually presents with a conductive hearing loss that can be addressed with bone conduction hearing aids, or in select patients, atresiaplasty surgery. It is essential that children with bilateral congenital aural atresia be fitted with bone conducting hearing aids as soon as possible. The formation of cholesteatoma in partially atretic ears should be suspected. In children where cholesteatoma is not suspected, imaging should occur at 4-6 years. As bone conducting technology advances, the number of patients treated with atresiaplasty has and will continue to decline.

Due to the heterogeneous tissue and varied structures in the ear and lateral skull base, the neoplasms that may arise are similarly varied. They range from benign lesions (for which observation is acceptable) to aggressive malignancies which require wide resection, often with sacrifice of vascular or neural structures. In general, for benign neoplasms, optimal management depends on weighing the risks of tumor progression and against potential morbidity of resection or other treatment. Imaging is a critical part of diagnosis and surgical planning for both benign and malignant neoplasms.

This module reviews the diagnosis and management of external ear disorders. External ear disorders are extremely common and most frequently bacterial in etiology, but may arise from a fungal or viral source.  They are often associated with anatomic abnormalities, water exposure, local ear trauma, or underlying dermatologic or immune disorders.  Treatment involves careful ear debridement and topical therapy.  Unusual or resistant infections should be cultured. Surgery is rarely indicated. 

The temporal bone is a highly complex anatomic region of the head and neck. This region can harbor various disease processes that can result from locoregional to systemic symptoms. Different disease processes are better evaluated by different imaging modalities and choosing the right imaging test itself can be challenging at times. Once the appropriate imaging modality has been undertaken, and the diagnosis made, identifying the normal and affected structures within the temporal bone is important as that can dictate the appropriate medical and surgical intervention needed. 

Intraoperative neurophysiologic monitoring is a valuable tool in otologic and neurotologic procedures. While intraoperative monitoring is not a substitute for good surgical technique, monitoring can provide valuable real time neural integrity feedback allowing for awareness and opportunity to change surgical maneuver. Current opinion holds that facial nerve monitoring is cost effective and beneficial for otologic and neurotologic surgery, and its use, at the discretion of the operating surgeon, can reduce the risk of iatrogenic facial nerve injury. 

Reviews pathology and differential for acute facial nerve weakness.  Reviews anatomy, technique, and application of facial nerve testing.  Identify timing of useful, actionable information.  Review role of surgery in acute facial nerve weakness.

This module outlines the tests necessary as part of a comprehensive vestibular assessment. It addresses the role of vestibular testing in evaluating both the central and peripheral vestibular systems. Various tests are described and detail is provided on how each test can be used by the clinician to identify a potential location insult and etiology of symptoms. The module commences with case studies of common vestibular pathologies and how testing is applied in these situations.

The peripheral vestibular system develops from the otic placode and interacts with the central vestibular system in order to maintain posture and balance.  The peripheral vestibular system consists of the semicircular canals and the otolith organs (utricle and saccule) involved in detection of angular and linear acceleration/movement, respectively.  The output of the vestibular system are reflexes such as  vestibuloocular reflux, vestibulocolic and vestibulospinal reflexes.  Vestibular hair cells play a role in detecting motion and acceleration.  Balance function depends on the vestibular s

Audiologic testing has amazing breadth and depth. It covers everything from routine screening to testing a specific portion of the auditory pathway. The key is knowing when and why to utilize a specific test. In many cases, an in depth understanding of the tests will help with your understanding of the disease process.

Sound energy is in the form of longitudinal pressure waves and for hearing, the sound needs to travel from the air medium to the fluids of inner ear.