Otology and Skull Base Surgery

Otology and Skull Base SurgeryResearch into hearing disorders at Mayo Foundation currently center around three concepts, hearing preservation, hearing restoration and auditory rehabilitation. Incremental advances in our understanding of the molecular and physiologic basis for hearing loss gained through basic science research and clinical studies have led to new and improved therapeutic options for patients. These advances are made possible by the close collaboration with expert colleagues in neurophysiology, rheumatology, pathology, radiology and audiology.

At present, our ability to restore or rehabilitate a hearing loss is limited, and therefore hearing preservation is of great importance. There are many different causes of hearing loss and the immune system may play an important role in a large number of cases. We have been actively investigating the basic science of autoimmune inner ear disease (AIED) while in parallel we investigate novel ways of treating patients with this disorder. The immune system can be modulated by the use of medicines such as Prednisone. What medicines to use, and how best to administer them is being investigated.

Patients with Meniere's Disease suffer from disabling vertigo and a progressive hearing loss. Many of our current treatment options for managing the vertigo result in a partial or complete hearing loss. Our group has been a leader in investigating and refining a method of treating the dizziness that allows for hearing preservation in the majority of cases.

The ability to restore hearing after damage to the inner ear has occurred would benefit a tremendous number of patients. The capability of inner ear structures to regenerate was once thought to be quite limited, but we now know that the most commonly injured structure, the outer hair cell can, and does, regenerate. Progress has been made in identifying the growth and neurostimulating factors important in the recovery of outer hair cells and other inner ear structures. We now have the surgical techniques and equipment to safely implant devices or introduce medications to the inner ear. It is even possible to introduce new genetic information that can produce missing or defective proteins or growth factors. Further advances in this promising area will require cooperation with biotechnology companies to develop the necessary drug delivery systems.

If we cannot preserve, or restore hearing, then we must consider hearing rehabilitation options such as hearing aids, cochlear implants, brainstem implants and hybrid devices (a cochlear implant and conventional hearing aid combination). Our cochlear implant team is well established and we are currently investigating under FDA protocol the two most advanced devices available. These areas of research are discussed further in the audiology section.

In addition to the above mentioned primary areas of interest the group is involved in numerous smaller projects. These include studying the application of new imaging techniques (i.e.3-D magnetic resonance imaging, positron emission scanning), assessing the role of stereotactic radiation in the treatment of acoustic neuromas and participation in the development of a modification of the auditory brainstem response test ("stacked" ABR).