hbep
08-22-2003, 08:41 AM
People often ask about which specialist to see for an inner ear disorder. This info about the types of specialists dizzy people are sent to was posted on the net by by Sue Pesznecker, a vestibular research nurse. It might be useful to direct new people on the board to this info - it's very helpful.
Written by Sue Pesznecker.
"Entry-level position is the otolaryngologist or ENT (ear-nose-throat).These docs have completed med school, a 3-5 year general surgery residency,
and a 2-3 year ENT residency. They may or may not become board-certified.ENTs take care of a wide variety of conditions involving the ears, nose, and
throat-- mostly sinuses, tonsils, ear tubes, etc. Many of them become head/neck surgeons and care for cancer patients few of them may become self-educated about the inner ear, but their training actually contains little inner ear work.
Next up the ladder is the otologist. He/she is an ENT who, following their ENT residency, has completed a 2-3 year fellowship in otology. A fellowship
is a course of study in which the candidate aligns themselves with a specific center/clinician(s) and spends 2-3 years at their side, trying to learn as much as possible from them. Otologists limit their practice to treatment of the ear alone-- most of them are fairly knowledgeable in "inner ear", but much of their skill depends on where they took their fellowship, as they will absorb that locale's knowledge and preferences above everyone else. There is no board certification in the sub-specialty of otology, but usually a certificate is given.
Last (highest) step is neurotology (also called neuro-otology or oto-neurology). This is an otologist who has taken an additional 2-3 year fellowship in neuro-otology. Neurotologists treat diseases of the inner ear and its connections with the brain and central nervous system. There are very few neurotologists, but if anyone will understand the inner ear, it's
them. There is no board certification in the super-sub-specialty of neurotology, but usually a certificate is given.
A neurologist is an unrelated specialist who studies diseases of the brain and central nervous system. They will know little or nothing about inner
ear problems, unless they've intentionally educated themselves. In any cases, a neurologist wouldn't and shouldn't be the main caregiver for
someone with an inner ear problem."
I would also add that tempero mandibular joint disorder is another condition which can also cause dizziness and other ear symptoms. Although any of the above specialists should be able to spot this condition it is sometimes missed by them completely. It often takes a dental hospital, oral surgeon, or a dentist with a great deal of experience of treating tmjd to diagnose it. Regular dentists are not required to do any extensive further study in to tmjd and sometimes don't recognise it, especially if it predominantly presents as ear symptoms and/or dizziness without jaw symptoms.
I also think it's worth noting that she says ENT 's training actually contains 'little inner ear work.' This would explain the vast amount of mis diagnosies that people get from ENT's, (anxiety being a hot favourite) or alternatively no diagnosis at all, leaving them bewildered. If you are getting nowhere with your ENT, run don't walk to your nearest neuro otologist. I did and I'm glad I did.
Written by Sue Pesznecker.
"Entry-level position is the otolaryngologist or ENT (ear-nose-throat).These docs have completed med school, a 3-5 year general surgery residency,
and a 2-3 year ENT residency. They may or may not become board-certified.ENTs take care of a wide variety of conditions involving the ears, nose, and
throat-- mostly sinuses, tonsils, ear tubes, etc. Many of them become head/neck surgeons and care for cancer patients few of them may become self-educated about the inner ear, but their training actually contains little inner ear work.
Next up the ladder is the otologist. He/she is an ENT who, following their ENT residency, has completed a 2-3 year fellowship in otology. A fellowship
is a course of study in which the candidate aligns themselves with a specific center/clinician(s) and spends 2-3 years at their side, trying to learn as much as possible from them. Otologists limit their practice to treatment of the ear alone-- most of them are fairly knowledgeable in "inner ear", but much of their skill depends on where they took their fellowship, as they will absorb that locale's knowledge and preferences above everyone else. There is no board certification in the sub-specialty of otology, but usually a certificate is given.
Last (highest) step is neurotology (also called neuro-otology or oto-neurology). This is an otologist who has taken an additional 2-3 year fellowship in neuro-otology. Neurotologists treat diseases of the inner ear and its connections with the brain and central nervous system. There are very few neurotologists, but if anyone will understand the inner ear, it's
them. There is no board certification in the super-sub-specialty of neurotology, but usually a certificate is given.
A neurologist is an unrelated specialist who studies diseases of the brain and central nervous system. They will know little or nothing about inner
ear problems, unless they've intentionally educated themselves. In any cases, a neurologist wouldn't and shouldn't be the main caregiver for
someone with an inner ear problem."
I would also add that tempero mandibular joint disorder is another condition which can also cause dizziness and other ear symptoms. Although any of the above specialists should be able to spot this condition it is sometimes missed by them completely. It often takes a dental hospital, oral surgeon, or a dentist with a great deal of experience of treating tmjd to diagnose it. Regular dentists are not required to do any extensive further study in to tmjd and sometimes don't recognise it, especially if it predominantly presents as ear symptoms and/or dizziness without jaw symptoms.
I also think it's worth noting that she says ENT 's training actually contains 'little inner ear work.' This would explain the vast amount of mis diagnosies that people get from ENT's, (anxiety being a hot favourite) or alternatively no diagnosis at all, leaving them bewildered. If you are getting nowhere with your ENT, run don't walk to your nearest neuro otologist. I did and I'm glad I did.