MEMBERS of the Workshop, it is indeed a privilege to present the opening paper on neuro-otology. The advances made in the understanding of vestibular physiology, in the development of sophisticated tests of auditory and vestibular function, and especially in the surgical management of neuro-otological disorders, emphasize the urgency for every otolaryngologist to be prepared to perform a basic clinical evaluation in his office. This, of course, includes a careful history, which, in most patients, will suggest the best diagnostic possibilities. This morning I would like to present a plan for a basic office examination of every patient who presents a symptom that could be due to an otological or neurological disorder.
The areas and systems which should be included are: otolaryngological examination; cranial nerves III through XII; nystagmus; coordination, gait, and station which includes cerebellar function; and examination for bruits. Rather than adhere to an anatomic pattern, it is better