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Treatments and drugs
By Mayo Clinic staffThere are three options for managing an acoustic neuroma: periodic monitoring, radiation and surgical removal.
Monitoring
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 hearing loss or other difficulties, you may need to undergo treatment.
Stereotactic radiosurgery
Stereotactic radiosurgery, such as gamma-knife radiosurgery, enables doctors to deliver radiation precisely to a tumor without making an incision. The doctor attaches a lightweight headframe to your numbed scalp. Using imaging scans, your doctor pinpoints the tumor and then plots where to apply the radiation beams.
The purpose of radiosurgery is to stop the growth of a tumor. It's generally an option if you have a small tumor or if you're not a candidate for surgery. It may also be used for residual tumors — portions of a tumor that traditional brain surgery can't remove without damaging brain tissue.
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, facial weakness and balance problems.
Surgical removal
There are several techniques for removing an acoustic neuroma, but in general the goal of surgery is to remove the tumor, preserve the facial nerve to prevent facial paralysis and preserve hearing as much as possible. Performed during general anesthesia, surgery for an acoustic neuroma involves removing the tumor through the inner ear or through an incision in your skull. You may need to stay in the hospital from four to six days after the surgery, and recovery may take six weeks or more.
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:
- Leakage of cerebrospinal fluid through the wound
- Hearing loss
- Facial weakness
- Ringing in the ear
- Balance problems
- Persistent headache
- Acoustic neuroma. American Hearing Research Foundation. http://www.american-hearing.org/disorders/acoustic-neuroma/. Accessed June 14, 2010.
- Vestibular schwannoma (acoustic neuroma) and neurofibromatosis. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/hearing/acoustic_neuroma.asp. Accessed June 14, 2010.
- Park JK, et al. Vestibular schwannoma (acoustic neuroma). http://www.uptodate.com. Accessed June 14, 2010.
- Radiosurgery practice guideline initiative: Stereotactic radiosurgery for patients with vestibular schwannomas. International RadioSurgery Association. 2006: #4-06. http://www.irsa.org/AN%20Guideline.pdf. Accessed June 14, 2010.
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