Neuro-otology is a subspecialty that includes disorders of the peripheral and central auditory and vestibular systems. The majority of neuro-otologists have come from the field of otolaryngology with the focus on the ear with its vestibular and auditory functions without reference to central auditory processing within the central nervous system. A variety of causes of dizziness and disequilibration are accompanied by auditory complaints and, thus, neurologists who choose to deal with dizzy patients should be familiar with both vestibular and auditory disorders.

In the assessment of hearing, abnormalities of the auditory system may be a manifestation of a systemic and possibly life-threatening disorders. The examiner should obtain a history of past, present, and familial audiologic and otologic complaints. One of the best techniques for determining whether there is an auditory disorder is to ask family members or co-workers whether there appears to be difficulty in hearing. The patient often may be unaware of hearing dysfunction, particularly if it is unilateral. The first few minutes spent talking with the patient or relatives will help determine the direction the inquiry should take. Subsequent examination of the patient and preliminary audiologic findings, if any, determine how inclusive examination should be and what subsequent tests should be ordered. It is important to remain aware that audiologic tests do not always provide an exact diagnosis. Results of the audiologic test battery must be integrated with the neurological, otoneurological, and radiological information to determine the most accurate diagnosis.