A neuro-otologist is a physician who has completed a five-year (minimum) accredited residency training program in otolaryngology-head and neck surgery (ear, nose and throat surgery) followed by advanced fellowship training in otology/neuro-otology. Although the general otolaryngologist is trained to manage disorders of the ear, the neuro-otologist usually restricts his/her practice to ear-related problems. This includes the evaluation and management of tinnitus (noises in the ear), all types of hearing loss, dizziness and imbalance, facial nerve disorders and difficult or persistent infections. In addition, the neuro-otologist performs surgical procedures for repair of eardrum perforations, hearing reconstruction (including cochlear implants), control of long-standing infections, removal of tumors (benign and malignant) that involve the ear, management of certain types of dizziness (especially Meniere's Disease) and revision surgery for initial procedures that may have been unsuccessful. The neuro-otologist often works in conjunction with a neurosurgeon for the management of skull-base lesions that affect the ear (such as acoustic neuromas and other tumors). In addition, a full range of diagnostic hearing and balance testing is available to the neuro-otologist.