Otology (ear medicine and surgery) doctors have many diagnostic tests at their disposal. In this video, CNC Hearing and Balance Neurotologist Moises Arriaga discusses the tests that assist in diagnosing the cause of an illness.
In otology, or ear medicine and surgery, like all of medicine, the history and the physical exam are the most important parts of deciding what the condition is and how to come up with a treatment plan. However, we’re fortunate in ear medicine and surgery that we also have access to different types of tests.
We frequently will do imaging tests, and there are two types. CAT scan testing helps us look at the bones. It lets us look at the bones of the middle ear. Let’s us look at the bones surrounding the ear, separating it from the brain, and to see if there’s any bone destruction.
MRI scans are helpful to look at the nerves, particularly when we’re looking for tumors. It’s also helpful in certain ear infections called cholesteatomas. There are some special signals that the MRI will give us to distinguish between scar, inflammation, and cholesteatoma, and that helps us plan the treatment and not miss important conditions that could get worse if they’re not addressed.
The other category of tests, which are very helpful, are tests of the inner ear and balance. The most common is the hearing test or audiogram, and we’re able to test how the nerves are working, how the mechanics are working, how the eardrum is moving, and how the little reflexes work.
We can also do special balance tests, and some of the ones that we use that are very helpful are the rotational chair test. That lets us know how well the inner ear is telling the brain where the eyes need to be when you’re moving. It also helps us identify inner ear hypersensitivity or migraine type dizziness, as well as situations where one ear is weaker than the other and how well the patient has compensated. We’re able to test each ear separately by putting cold and warm air or water in the ear and recording the eye movement, or we can record the electricity coming from the ear, and that can help us identify if there’s too much fluid pressure in the inner ear. It can help us see if the balance nerves themselves are weak, or it can help us see how effectively the sound is progressing from the ear to the brain.
With all of these sources of information, we’re able to pinpoint the cause for the patient and plan a treatment strategy to try to help with the symptoms.