Your acoustic neuroma treatment may vary, depending on the size and growth of the acoustic neuroma and if you're experiencing symptoms. To treat acoustic neuroma, your doctor may suggest several possible treatments.
If you have a small acoustic neuroma that isn't growing or is growing slowly and causes few or no signs or symptoms, you and your doctor may decide to monitor it, especially if you're an older adult or otherwise not a good candidate for treatment.
Your doctor may recommend that you have regular imaging and hearing tests, usually every six to 12 months, to determine whether the tumor is growing and how quickly. If the scans show the tumor is growing or if the tumor causes progressive symptoms or other difficulties, you may need to undergo treatment.
Your doctor may recommend stereotactic radiosurgery (ster-ee-oh-tak-tik ray-dee-oh-sur-jur-ee) if you have an acoustic neuroma. Some very large tumors can't be treated with stereotactic radiosurgery. The goal of stereotactic radiosurgery is to stop the growth of a tumor, preserve the facial nerve's function and possibly preserve hearing. However, a study has found that many people gradually lose their hearing within 10 years after stereotactic radiosurgery.
In stereotactic radiosurgery, such as Gamma Knife radiosurgery, doctors deliver radiation precisely to a tumor without making an incision. The doctor attaches a lightweight head frame to your scalp, which has been numbed. Using imaging scans, your doctor pinpoints the tumor and then plots where to direct the radiation beams.
It may take weeks, months or years before the effects of radiosurgery become evident. Your doctor will monitor your progress with follow-up imaging studies and hearing tests. Risks of radiosurgery include hearing loss, ringing in the ear, facial weakness, facial numbness, balance problems and treatment failure (continued tumor growth). Very rarely, the radiation could cause a cancer in the treated area in the future.
You may need surgery to remove an acoustic neuroma. Your surgeon may use one of several techniques for removing an acoustic neuroma, depending on the size of your tumor, preoperative hearing status and other factors. The goal of surgery is to remove the tumor, preserve the facial nerve to prevent facial paralysis and preserve hearing when possible.
Performed during general anesthesia, surgery for an acoustic neuroma involves removing the tumor through the inner ear or through a window in your skull. The entire tumor may not be able to be completely removed in some cases, such as if the tumor is too close to important parts of the brain or the facial nerve.
Surgery can create complications, including worsening of symptoms, if certain nerve or cranial structures are affected during the operation. These risks are often based on the size of the tumor and the surgical approach used. Complications may include:
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- Leakage of cerebrospinal fluid through the wound
- Hearing loss
- Facial weakness
- Facial numbness
- Ringing in the ear
- Balance problems
- Persistent headache
- Infection of the cerebrospinal fluid (meningitis)
- Stroke or brain bleeding
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- Support group overview. Acoustic Neuroma Association. http://www.anausa.org/index.php/support-groups. Accessed Dec. 19, 2012.
- Caregivers overview. Acoustic Neuroma Association. http://www.anausa.org/index.php/caregivers. Accessed Dec. 19, 2012.
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- Carlson ML, et al. Long-term audiometric outcomes following low-dose stereotactic radiosurgery for vestibular schwannoma: Patterns of hearing loss and variables influencing audiometric decline. Journal of Radiosurgery. In press. Accessed Feb. 27, 2013.
- U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed Feb. 27, 2013.
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