Acoustic Neuromas & How We Treat Them

Acoustic Neuromas & How We Treat Them

By Douglas D. Backous, MD
Medical Director, The Center for Hearing and Skull Base Surgery

Acoustic Neuromas, also known as vestibular schwannoma, is a slow growing  benign tumor on the balance nerve connecting the inner ear to the brain.

This is an uncommon condition, found in roughly 1 in 100,000 people. The most common symptoms include hearing loss, tinnitus (ringing in your ear), and vertigo (a feeling of imbalance). Because these symptoms are present with many conditions, it is important to see your doctor if they persist more than a few weeks. Your healthcare provider will make a referral to an ENT surgeon or to a Neurotologist if they feel you need further evaluation. Neurotology is a sub-specialty of  otolaryngology (ears, nose, and throat) specializing in the neurological conditions of the ears and brainstem (also referred to as skull base surgery. if an acoustic neuroma is suspected). The neurotologist may conduct a clinical evaluation, hearing and balance tests and imaging studies, such as MRI, to make the diagnosis. 

Once diagnosed, there are many options to consider:

  • Observation with a repeat MRI scan in 6 months. If the scan shows no growth,  repeat scanning at annual intervals for 3 years is recommended. If the tumor size is stable, the scan will be repeated after 2 years thereafter. If at any interval the tumor grows, the other treatment options should be considered.
  • Radiosurgery is an option which delivers targeted radiation to the tumor in an outpatient setting. The Gamma Knife and CyberKnife are two of the options offered and treatment is completed in 1-5 sessions.

  • Surgical removal of the tumor. There are several hearing preservation approaches for removing the acoustic neuroma and the neurotologist will provide detail on these options.
  • Surgical removal and radiation therapy may be used in combination if the entire tumor cannot be removed or if over time the tumor grows back.

Remember that acoustic neuromas are uncommon and the side effects are also associated with many other causes. Talk with your health care provider first and if you need more specialized care, the neurotologists can provide the expertise needed.

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