Specialty spotlight – audiovestibular medicine

Dr Brigid Mac Ardle and Dr Rohani Omar discuss why they love audiovestibular medicine, and how it supports research careers and creates a good work/life balance.

Introduction to audiovestibular medicine

Audiovestibular medicine is an expanding medical specialty which focuses on improving the quality of life of people of all ages who have hearing and balance disorders. This is achieved through the investigation, prompt diagnosis and management of disorders such as hearing loss, tinnitus, hyperacusis, dizziness and vertigo. Being a medical specialty, audiovestibular should not be confused with audiology or ENT surgery although there is some overlap.

The outcome of managing hearing and balance disorders is very rewarding. Whether it's by investigating and rehabilitating a baby with congenital hearing loss throughout their life, providing reassurance to a patient with acute vertigo that they don't have a stroke but a treatable inner ear disorder, or providing a definite diagnosis and management for a patient who has seen several doctors and undergone several investigations for their chronic dizziness, the audiovestibular physician derives great satisfaction from making a huge difference to the wellbeing and the quality of life of their patients.

Dr Victor Osei-Lah, consultant audiovestibular physician

Training and working in audiovestibular medicine

Audiovestibular medicine resources

RCP resources

Historical highlights from the library, archive and museum collection

Hearing aids were first created in the 17th century with the use of the ear trumpet – an example of which can also be seen on display at the RCP, as can some silver hearing aids in their original box, made by 'The Naturton Co, 83 Pall Mall, SW1' in London c.1840. They are an early example of hearing aids designed to be placed in the ear canal.

The library book Antique hearing devices by Elisabeth Bennion (Brighton: Vernier Press, 1994), surveys the history of hearing devices such as ear trumpets, ‘conversation tubes’ and ‘bone-conduction devices’. The volume includes some fascinating and entertaining illustrations such as Cartoon from Punch, 1878, illustrating the directional use of an ear trumpet and Punch cartoon of 1865, illustrating use of a coversation [sic] tube.

One of the oldest books in English in the RCP library concerning hearing loss is John Bulwer’s Philocophus: or, The deafe and dumbe mans friend, published in London in 1648. Bulwer (1606–1656) was a physician and wrote several books concerning communication. The book is devoted to promoting the benefit of learning to lip-read, a skill that Bulwer describes as ‘subtile art, which may inable one with an observant Eie, to Heare what any man speraks by the moving of his lips'. It presents the story of a deaf Spanish man, Don Luis Velasco, who was taught to lip-read and to speak by a schoolmaster.

Bulwer dedicated this book to Sir Edward Gostwick (1619–1659) and his younger brother William, both of whom were deaf from birth. He writes that although lacking the faculty of speech, the Gostwicks have at their disposal ‘your whole Body, for a Tongue, having a language more natural and significant, which is common to you with us, to wit gesture, the generall and naturall language of Humane nature’. Bulwer was a pioneer in the cause for the education of deaf people, and in this book he also sketches out his ideas for an academy for deaf people.

The foundations for what is often called occupational audiological medicine were laid by Williams Burns FRCP. He conducted studies with D W Robinson in the 1960s on the effect of industrial noise on the hearing of workers.

In 2008 the RCP published the working party report Hearing and balance disorders: achieving excellence in diagnosis and management. Our collections include both copies of the report and records of the working party (although the latter are accessible only to RCP fellows until 2024).