The noble aim of providing comprehensive care for our patients is, ultimately, what should motivate us. However, many obstacles stand in the way of this goal. One of these is the vast scope of medicine and the consequent need to specialise our knowledge in order to strive for the best possible outcomes for our patients. This division, giving rise to technical and scientific disciplines, results in the existence of boundaries and the need for interdisciplinary work. This is where otoneurology comes in. Vertigo undoubtedly falls within the scope of Otorhinolaryngology. But it also falls within the scope of other specialities, notably Neurology.
The aim of the APO is to further knowledge in this field and thereby assist doctors and patients in various areas, particularly the often unclear and complex diagnosis of vertigo. There cannot, therefore, be a rigid division between ENT and Neurology in this field, and this is where Otoneurology’s unquestionable importance lies. As it concerns several specialities, it is not justified for it to remain merely an appendix or section of any one of them. In fact, a doctor specialising in this area must deepen their knowledge of anatomical physiology, semiology, pathology and therapeutics relating to a range of symptoms that may originate either in the inner ear, or in the pontocerebellar angle, or in the central pathways of hearing and balance.
We are all aware of the significant advances this field has made over the last two decades, to the extent that we have come to the conclusion that vertigo should be assessed and treated in a dedicated clinic, using diagnostic tools that enable us to study the functioning of the vestibular system – in its ampullary and otolithic aspects (whilst taking into account low- and, above all, high-frequency head movements) and the vestibular evoked potentials.
The patient must be treated as a whole, which requires smooth and close interdisciplinary communication. For this reason, in our view, everything relating to this area within the various scientific societies should be centred on the APO. And the APO should seek to have colleagues within its ranks who devote the best of their time and effort to this field.
It is with this aim in mind that we have been organising conferences, courses and scientific meetings, which have sought to serve both as a means of disseminating knowledge to younger members and as a forum for exchange amongst the more experienced.
However, we believe that the proliferation of these meetings within each speciality is detrimental, as it leads to a dispersal of the efforts and financial resources that are essential for them.
We propose that efforts should be concentrated within each area and on the exchange between them, under the supervision of the various scientific societies or associations. It is these bodies which, having no financial objectives and pursuing purely scientific aims, can play a pivotal role here. There can be no excuses that they do not function properly or that they are the preserve of a particular group. They have sovereign General Assemblies where, provided that professionals do not shirk their duty to participate, everything can be rectified. And it is these bodies that can contribute to the analysis of medico-legal issues, which are becoming increasingly prevalent.
