Neurotology & Skull Base Surgery
Specialist care for complex ear disease, hearing loss, vertigo, facial nerve disorders and selected skull base conditions.
Book a ConsultationWhat Does "Neurotology" Actually Mean?
Most people have heard of an ENT specialist, but "Neurotologist" is a less familiar word. A general ENT surgeon is trained to manage common ear problems — wax, infections, routine hearing loss.
Neurotology is a sub-specialty within ENT that focuses specifically on the inner workings of the ear. This distinction matters because the ear is one of the smallest, most tightly packed anatomical spaces in the body — a few millimetres separate hearing structures from the balance organs, the facial nerve, and the skull base. Precision here isn't optional.
I completed a rigorous, one-year clinical hands-on fellowship accredited by the North American Skull Base Society (NASBS) at the University of Cincinnati, in direct affiliation with the Mayfield Clinic. Unlike purely observational programs, this intensive hands-on clinical fellowship placed me at the operative table managing primary surgical responsibilities. Training directly alongside world-renowned authorities in neurotology and skull base surgery, I managed patients presenting with the most intricate and critical pathologies referred from across the globe.
This background provides me with high-level diagnostic precision and micro-surgical expertise to not simply remove disease, but to achieve appropriate disease control while protecting important structures such as the facial nerve, hearing apparatus and balance organs whenever possible, and to handle complex otologic, vestibular, and skull base disorders — experience that has directly shaped how I manage complex patients in India.
Ear, Hearing, Balance & Skull Base Care
Hearing Loss & Rehabilitation
Hearing loss can arise from problems in the outer or middle ear, damage to the inner ear or hearing nerve, or a combination of these.
Conductive Hearing Loss
Caused by problems that interfere with the transmission of sound, such as:
- Ear drum perforation
- Middle-ear fluid or infection
- Ossicular problems
- Otosclerosis
- Chronic ear disease
Sensorineural Hearing Loss
This occurs when the inner ear or hearing pathway is damaged. Depending on its severity, treatment may involve hearing aids, bone-conduction devices or cochlear implantation.
Cochlear Implants & Hearing Devices
A hearing aid amplifies sound — it makes existing sound louder for an ear that still has some working hearing.
A cochlear implant is different — it's a small electronic device, partly surgically placed, that bypasses the damaged part of the ear entirely and sends sound signals directly to the hearing nerve. It's used when hearing loss is severe enough that amplification alone no longer helps.
Chronic Ear Disease & Cholesteatoma
Persistent ear discharge, repeated infections, hearing loss or a perforated eardrum may indicate chronic middle-ear disease.
A cholesteatoma is an abnormal collection of skin within the middle ear or mastoid. Although it is not a cancer, it can progressively damage the surrounding bone and important structures.
In many cases, surgery is required to remove the disease and create a safe, dry ear. The surgical approach depends on the extent and location of the disease and the condition of the hearing structures.
Otosclerosis & Stapes Surgery
Otosclerosis is an abnormal bone-remodelling condition affecting the middle ear and can cause progressive conductive hearing loss.
Stapes surgery is a highly precise procedure designed to improve sound transmission to the inner ear. Whether surgery or hearing amplification is appropriate depends on the individual patient's hearing level, anatomy and circumstances.
Vertigo, Dizziness & Balance Disorders
Not every episode of dizziness originates in the ear. Conditions such as BPPV, Ménière's disease, vestibular neuritis, vestibular migraine and other vestibular disorders can produce vertigo or imbalance, while neurological, cardiovascular and other conditions can cause similar symptoms.
A detailed history and proper evaluation identifies which system is responsible before treatment starts.
Tinnitus
Tinnitus is the perception of sound without an external sound source. It may occur with hearing loss, noise exposure, ear disease and several other conditions.
Unilateral tinnitus, pulsatile tinnitus, tinnitus associated with hearing loss, or tinnitus accompanied by neurological symptoms warrants appropriate evaluation rather than simply ignoring the symptom.
Facial Nerve Disorders
The facial nerve passes through the temporal bone in close proximity to the middle and inner ear. Facial weakness can occur because of several causes, including inflammatory conditions, trauma, chronic ear disease and tumours.
Sudden facial weakness requires prompt neurotological assessment.
Lateral Skull Base Surgery
The skull base contains critical nerves, blood vessels and structures connecting the ear with the brain. My skull base practice particularly involves lateral skull base disorders associated with the temporal bone and otologic structures. These may include:
- Vestibular schwannoma
- Cerebellopontine angle lesions
- Temporal bone lesions
- Facial nerve lesions
- Selected lateral skull base tumours
When Should You See a Neurotologist?
A specialist evaluation may be appropriate if you have:
- Unexplained or progressive hearing loss
- Hearing loss in one ear
- Persistent ear discharge
- Recurrent ear infections
- Cholesteatoma
- Chronic eardrum perforation
- Recurrent vertigo
- Persistent tinnitus
- Pulsatile tinnitus
- Sudden hearing loss
- Facial weakness
- A suspected vestibular schwannoma
- A temporal bone or skull base lesion
- Been advised to undergo complex ear surgery
- Been advised to undergo ear or skull base surgery and want a second opinion
With specialised training in Otology, Neurotology and Skull Base Surgery, Dr Kumaresh provides evaluation and treatment for complex ear, hearing, balance, facial nerve and selected lateral skull base disorders.
Book a Consultation
If you have unexplained hearing loss, recurring ear problems, persistent vertigo, facial weakness, or have been advised to undergo ear or skull base surgery, a detailed neurotology assessment can help clarify the diagnosis and the right path forward. Please bring any previous reports, scans and treatment history with you.
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