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Penn Neurotology offers the most advanced techniques and procedures to diagnose hearing loss and impairment, dizziness and/or balance disorders and skull base tumors that affect the ear and surrounding structures. Our multidisciplinary team consists of neurotologists, audiologists, radiation oncologists, head and neck surgeons, neurosurgeons and medical oncologists that collaborate to provide an accurate diagnosis using the following leading edge tests and tools:

Hearing Loss, Impairment and Tinnitus Diagnostic Tests and Tools:

  • Pure Tone and Speech Audiometry: This test measures how clearly you can hear. Patients sit in a large, sound-treated booth and either listen to tones or speech through ear plugs or feel vibrations through a device placed behind the ear.
  • Acoustic Immittance, Tympanometry and Acoustic Reflex Studies: A small probe is placed in the patient's ear canal to see how well the structures and muscles in the middle ear are working.
  • Otoacoustic Emissions: A microphone placed in the ear measures how well the hair cells of the inner ear respond to sound.
  • Auditory Brainstem Response Testing (ABR): ABR testing evaluates the nerve that runs from the inner ear to the brain. Electrodes are placed on the patient's scalp while they sit and listen to clicking sounds.
  • Examination by the doctor and targeted imaging studies.

Balance and Dizziness Disorder Diagnostic Tests and Tools:

  • Audiologic Assessment: Some inner ear disorders can cause both dizziness and hearing loss. Tone and speech audiometry assessments will demonstrate the type and degree of hearing loss, as well as how clearly words are heard. Acoustic immittance assessments examines inner ear function.
  • Posturography: This assessment determines how a patient uses visual, somatosensory and vestibular inputs to maintain balance. It also tests your ability to coordinate your lower and upper body reactions to remain in place when you lose balance.
  • Videonystagmography (VNG): VNG evaluates the vestibular-ocular reflex, which allows the inner ear to sense motion and provides stable vision during head and body movements. VNG results provide us with insight about inner ear function and the parts of the brain responsible for balance.
  • Rotational Chair Test: The rotational chair test evaluates how the inner ear responds to various types of motion and provides information about physiologic compensation status. In cases where both inner ears are weak, this test can show the extent of the weakness.
  • Vestibular Evoked Myogenic Potentials (VEMPS): VEMPs provide assessment of the part of the inner ear responsible for sensing gravity and various movements of the head and body.

Skull Base Tumor Diagnostic Tests and Tools:

  • Magnetic Resonance Imaging (MRI): An MRI is a diagnostic test that produces three-dimensional images of body structures using magnetic fields and computer technology. It produces very clear images of various types of nerve tissue and clear pictures of the brain stem and posterior brain. MRI of the brain can help determine many disorders, including evidence of prior mini-strokes.
  • Computed Tomography (CT or CAT scan): A CT scan uses a combination of X-rays and computer technology to produce images of the brain. A CT scan shows structures of the brain and evaluates for the presence of mass, fluid collection and/or signs of a stroke.
  • Bone Scan: This procedure entails injecting radioactive material into your bloodstream. The tumor absorbs the material and a special camera is used to produce an image using a computer. This way your doctor can locate the bone tumor and detect any spread of cancer into other organs.
  • Positron Emission Tomography (PET): A PET scan can detect changes in cells as they grow. Often used in conjunction with a CT, a PET/CT identifies tumor cells injected with a radioactive glucose so they can be compared with normal parts of the brain.

Intraoperative Advanced Imaging Technology for Skull Base Tumors:

  • TumorGlow®: Patients are injected with a dye that causes cancer cells that might normally be invisible to CT scans to "glow." During surgery, the tumors strongly glow under near-infrared cameras, guiding surgeons to cancerous tissue in areas where it was previously undetected.
  • 3D Endoscopy: Provides three dimensional visualization, improving depth perception during evaluation and surgery.
  • Neuroradiologic Mapping: Produces highly precise clinical imaging of advanced tumors within the central and peripheral nervous system, using both MRI and CT to best define tumors of the skull base and rule out anomalies that will not require surgery.
  • Interventional Angiography: Defines critical vascular structure and decreases blood loss during certain procedures. This is used to block off blood vessels to a tumor.
  • Cranial Nerve Monitoring: Used during surgery to identify and preserve vision, hearing, balance and facial expressions, as well as speech and swallowing.
  • Intraoperative Computer-Assisted Navigation: Used to identify the precise location of tumors in relation to surrounding vital tissues.
  • We work closely with neurosurgery and radiation oncology to offer the most cutting edge options for treatment of skull base tumors. 
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