Otology, Neurotology and Skull Base Surgery

• Contact Information
• Faculty
• Introduction Otology/Neurotology
• Skull Base Surgery
• Acoustic Neuroma

Contact Information

For more information about Otology/Neurolotology services provided at the University of Iowa, please contact appointment scheduling at 319-356-2201.

Faculty

• Bruce Gantz, MD
• Marlan Hansen, MD

Introduction Otology, Neurotology and Skull Base Surgery

This subspecialty service manages diseases and disorders of hearing, balance, cranial nerves, and the skull base.

Drs. Gantz and Hansen specialize in the management of neurosensory or inner ear hearing loss (ie, profound deafness acquired and congenital, sudden hearing loss, immune mediated hearing loss), chronic ear disease (ie, chronic infected ears, cholesteatoma), conductive hearing loss (ie, ossicular discontinuity, otosclerosis, tympanic membrane perforations, congenital anomalies), balance disorders (ie, Meniere’s disease, vertigo, etc), facial nerve disorders (ie, Bells palsy, traumatic injury, neuroma), tumors of the cranial nerves (ie, acoustic neuroma, other nerve tumors).

Skull Base Surgery

The “skull base” or “cranial base” refers that area of the skull that the brain rests upon.  This is one of the most complex areas of the body to perform surgery on as it is innervated with many of the facial nerves responsible for hearing, seeing and facial movement.  Additionally the area is densely packed with vessels keeping the brain supplied with oxygen and is the connection between the brain the spinal cord (the brainstem).

Any surgery in this area of the anatomy is very complex and requires the closest co-operation between different services to ensure a positive outcome.  A skull base team consisting of neurotologists, neurosurgeons, neurophthamologists, neuroradiologists and interventional radiologists manage large skull base disorders including:

• Canvernous sinus tumor
• Craniopharyngiomas
• livus chordomas
• Esthesioneuroblastoma
• Acoustic Neuromas (See Below)
• Orbital tumors
• Petroclival meningiomas
• Pituitary gland tumors
• Pharyngeal tumors
• Schwannomas
• Temporal bone tumors

Acoustic Neuromas

An Acoustic Neuroma is a slow-growing benign tumor that occurs in the Internal Auditory Canal that arises from the Vestibular Cochlear Nerve.  Symptoms of an acoustic neuroma include: Tinnitus (ringing in the ears), facial paralysis, dizziness and difficulty in balancing.  These symptoms may not become immediately apparent as the nerves surrounding this slow growing tumor have time to adapt.  Left unchecked this tumor is life threatening as it may eventually press against the brainstem.

The care team involved in the treatment of an acoustic neuroma includes Neurotologists (Otolaryngologist specializing in Neurotology), Neurologists, Interventional Radiologists and Radiation Oncologists.  While it is possible in some cases to treat an acoustic neuroma with radiation therapy the most preferred method is still microsurgery.  This very delicate procedure involves removing the tumor while seeking to preserve as much of the surrounding nerve tissue, so not as to cause hearing loss or facial paralysis.

Our center is one of the few centers nationwide with an excellent record for the successful removal of acoustic neuromas without causing significant facial paralysis or hearing loss. 

PACEMAKER, Fall 2006, PDF file “My spring adventure.”