Oto-Neuro-Ophthalmology Center

Dominik Straumann

doi:10.1177/2514183x17714120

Abstract

Neuro-otology and neuro-ophthalmology are clinical fields destined to be combined in a single interdisciplinary center that offers state-of-the-art diagnosis and treatment to patients with vertigo, dizziness, imbalance, eye movements disorders and disorders of the afferent visual pathways. This paper describes the organization of the Oto-Neuro-Ophthalmology (ONO) center at University Hospital Zurich, Switzerland. The ONO center combines physicians and other medical personnel from the departments of neurology, otorhinolaryngology, ophthalmology, and psychiatry as well as dedicated physical therapists. Patients, typically referred to the center by general practitioners or medical specialists, are comprehensively assessed and treated by considering all neurological, otological, ophthalmological, psychiatric and physiotherapeutic aspects of their disorders. Based on the referral, the patient is assigned to a triage examination (duration: 30 minutes; no later than 10 days after referral) or a full examination. The latter includes a complete assessment of the medical history, a bedside examination, a laboratory test battery and imaging procedures. Importantly, the ONO center is partnered by an experimental laboratory dedicated to vestibular and ocular motor research and formed by the academically active members of the ONO center. To justify the collaborative efforts that go into establishing and continuously upgrading an ONO center, outcome measures become increasingly important.

Highlights

Dizziness, vertigo, and imbalance are among the most frequent symptoms that cause patients to see their doctor.[1,2,3,4] The multitude of underlying diseases requires close collaborations of specialists from different disciplines to ensure optimal diagnosis and therapy.[5]
This article describes in short the organization of the ONO center, which has evolved since its foundation in 2004, when we combined the neuro-otological resources of the departments of neurology and otorhinolaryngology
Positional vertigo is the most common form of dizziness.[4]. This positional vertigo is elicited by changing the position of head relative to gravity

Summary

Introduction

Vertigo, and imbalance are among the most frequent symptoms that cause patients to see their doctor.[1,2,3,4] The multitude of underlying diseases requires close collaborations of specialists from different disciplines to ensure optimal diagnosis and therapy.[5] the Oto-Neuro-Ophthalmology (ONO) center at University Hospital Zurich combines physicians and other medical personnel from the Departments of Neurology, Otorhinolaryngology–Head and Neck Surgery, Ophthalmology, and Psychiatry and Psychotherapy. The staff of the ONO center include four attending senior physicians working part-time for the center, namely, Katja Komossa, MD (Department of Psychiatry and Psychotherapy), Arianne Monge, MD (Department of Otorhinolarynology), Alexander A Tarnutzer, MD (Department of Neurology), and Ghislaine Traber, MD (Department of Ophthalmology); four residents; four laboratory technicians; and a part-time secretary. Unless the patient is assigned to a triage examination, the first appointment is dedicated to a complete assessment of the medical history and to bedside tests. The patient is informed which laboratory tests and imaging procedures would be required to further delineate the diagnosis and prognosis and to help choosing a rational therapy

First appointment

ONO board

Canalith liberation maneuvers on motorized threeaxis turntable

Outcome measures

Conclusion