title: Myths in neurotology.
abstract: For many diseases the etiology of disordered function is unknown and therapy is either symptomatic or empirical. The empirical approach to therapy is acceptable to many physicians, particularly if a treatment can be based on some attractive, although unproven, concept of pathogenesis. A hypothetical explanation of disordered function can become widely popular in spite of a serious lack of scientific support. When evidence emerges that refutes the logic of a concept of pathogenesis, then that concept becomes a myth. Human temporal bone studies have identified several myths in neurotology that deserve our attention. Among these myths are the following: (1) cochlear otosclerosis is a common cause for sensorineural hearing loss, (2) idiopathic sudden sensorineural hearing loss is a vascular disorder that should be treated as a medical emergency, (3) the conductive component of hearing loss in Paget's disease is caused by ossicular fixation and therefore should be surgically correctable, (4) vascular loops should be considered as a possible cause for otherwise unexplained otologic symptoms, (5) surgical manipulations on the endolymphatic sac are scientifically sound therapies for selected cases of Meniere's disease, and (6) perilymph fistulas are a common cause for audiovestibular symptoms that are not related to a stressful incident.
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: H F
authors.initials: HF
authors.lastname: Schuknecht
mesh_terms: D004427:Ear Diseases / Q000150:complications / Q000628:therapy*; D006311:Hearing Disorders / Q000209:etiology*; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D008575:Meniere Disease / Q000601:surgery; D010001:Osteitis Deformans / Q000150:complications; D010040:Otosclerosis / Q000150:complications / Q000628:therapy; D013701:Temporal Bone