Acoustic Neuroma Removal
(Neurilemmoma, Vestibular Schwannoma)
Definition
An acoustic neuroma is a benign (noncancerous) tumor on the acoustic nerve leading from the brain to the ear. Acoustic neuromas grow relatively slowly, and may cause hearing loss, balance problems, facial numbness, and headaches.
The Acoustic Nerve
© 2008 Nucleus Medical Art, Inc.
There are three main treatment options for an acoustic neuroma:
- Careful monitoring
- Microsurgical removal
- Radiation therapy
This fact sheet focuses on microsurgical removal of an acoustic neuroma.
Reasons for Procedure
- Increasing growth of the tumor
- Concern that tumor size may become life-threatening
- Hearing problems
What to Expect
Prior to Procedure
You will take the following medications:
- Steroids—usually started 48 hours before surgery
- Antibiotic—given intravenously (into the vein) right before surgery, and continued for 24 hours after surgery
During Procedure
You will be given IV fluids, antibiotics, and anesthesia.
Anesthesia
General anesthesia will be used. You will be asleep for the procedure.
Description of the Procedure
Depending on your hearing status and the size and location of the tumor, your doctor will select one of the following surgical methods to remove the acoustic neuroma:
- Translabyrinthine—the doctor removes the mastoid bone and bone in the inner ear for access to the ear canal and the tumor. This approach is often used when hearing is already minimal.
- Retrosigmoid/Sub-occipital—an incision is made through an opening in the skull, behind the mastoid part of the ear. This approach is used for large or small tumors, and makes it easier for the surgeon to view the facial nerve and to save the hearing.
- Middle fossa—The tumor is removed from the upper surface of the internal ear canal beyond the inner ear. This approach is used when there is a good chance that hearing may be preserved.
After Procedure
You will spend at least one night in the intensive care unit for care and observation. During recovery, you may experience some of the following:
- Head discomfort
- Fatigue and sleepiness
- Emotional "lows"
- Headache
- Dizziness
- Nausea
How Long Will It Take?
The surgery takes about 6-12 hours. The exact length will depend on the size and location of the tumor.
Will It Hurt?
Anesthesia will prevent pain during the procedure.
Possible Complications
Side effects may be temporary or permanent. They include:
- Hearing loss
- Excessive eye dryness
- Difficulty with balance
- Tinnitus
- Facial weakness and numbness on the side of the tumor
- Headaches
- Cerebrospinal fluid leak. This may present as clear fluid leakage from the nose, or fluid collecting under the incision.
Average Hospital Stay
Recovery time in the hospital will take 4-7 days.
Postoperative Care
Full recovery typically takes 4-6 weeks.
Outcome
Successful completion of the surgery results in complete removal of the tumor, and minimal additional hearing loss. You should have MRI scans regularly over the next several years to check for recurrence.
RESOURCES:
American Hearing Research Foundation
http://www.american-hearing.org/index.jsp
National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov
CANADIAN RESOURCES:
The Canadian Hearing Society
http://www.chs.ca/
Canadian Society of Otolaryngology
http://www.entcanada.org/default.asp
References:
Acoustic Neuroma Association website. Available at: http://anausa.org/ .
International Radiosurgery Association website. Available at: http://www.irsa.org/ .
Last reviewed March 2008 by Elie Rebeiz, MD, FACS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.
