Acoustic Neuroma (Vestibular Schwannoma)
Acoustic neuromas (also known as vestibular schwannomas) are non-cancerous tumors that arise from the nerve between the brain and inner ear. This nerve is involved in hearing and balance control. Acoustic neuromas are typically slow-growing tumors that over time displace the surrounding tissue areas.
Presenting symptoms can include tinnitus (ringing in the ear), hearing loss and balance difficulties. Larger tumor can cause facial numbness, facial weakness, headaches or symptomatic brainstem compression.
Treatment options include observation (for small tumors), radiosurgery and surgical resection. Treatment is determined by symptoms, tumor size and patient age and health.
There are three surgical approaches. The middle fossa approach is used for small tumors where hearing preservation is the goal. The retrosigmoid approach is also used for hearing preservation and for larger tumors. The translabyrinthine approach is utilized for larger tumors where hearing is already compromised.
- Please make sure that you either bring all MRIs and CT scans of your brain with you or, preferably, that they are sent to our clinic in advance. Our office staff can assist you with this.
- Bring a friend or family member. It always helps to have another set of ears.
- Write down any questions you have in advance.
A 42-year-old woman came into our clinic complaining of very mild right sided hearing loss. Her MRI (Figure 1) demonstrated an 8 mm right-sided acoustic neuroma. The treatment that was determined to be appropriate was surgery. We removed her tumor via a right middle fossa approach.
The patient had an excellent clinical outcome with preservation of both right-sided hearing and facial nerve function (Figure 2).
A 30-year-old man came into our clinic complaining of headaches and problems with balance. His MRI (Figure 3) demonstrated a 4.5 cm left-sided acoustic neuroma. The treatment that was determined to be appropriate for him was surgery. He underwent a retrosigmoid craniotomy for resection of the tumor. His postoperative MRI demonstrated no residual tumor (Figure 4).
The patient is doing very well with full preservation of his facial nerve function after surgery.
A 56-year-old woman came into our clinic with dizziness and hearing loss. Her MRI (Figure 5) demonstrated a 3-cm left-sided acoustic neuroma. The treatment determined to be appropriate for her was surgery. She underwent a left-sided translabyrinthine approach. Her postoperative MRI demonstrated total resection of the tumor (Figure 6). The bright area (*) is fat packing use to fill approach site.
The patient is doing very well with full preservation of her facial nerve function after surgery.