Acoustic neuromas are benign brain tumors, located on the nerve responsible for hearing and balance, which explains the symptoms that likely led to your diagnosis, such as hearing loss and/or balance issues. Acoustic neuromas can vary in size and location and your treatment options depend upon your individual tumor and other health factors.
Many patients will not require treatment for their acoustic neuroma and will instead be monitored for changes in symptoms or tumor growth. Other patients who require treatment by acoustic neuroma specialists will either undergo stereotactic radiosurgery or traditional surgery. Based on the specifics of your condition, your symptoms, age and overall health, your doctor will recommend what he or she feels is most appropriate for you.
To help you better understand each of these treatment options, acoustic neuroma specialists will help explain each available approach along with the benefits and risks of each. Whether you are still in the treatment planning phase with your doctor or already have your procedure scheduled, this can help you better understand why your doctor has made a particular recommendation.
Observation
If your doctor has recommended observation, it may be because your symptoms are mild and manageable or your individual tumor and/or health status may cause increased risk during traditional or stereotactic radiosurgery. Your doctor will consider whether the benefits of these treatments outweigh the risks and may decide that observation is the best option. Many people with acoustic neuromas will never need treatment and will never suffer from symptoms.
Benefits
- Because there is no surgery, there are no surgical risks.
- These tumors are often found incidentally following an event, such as an accident, when they are detected on diagnostic images. Otherwise, patients frequently would not know about their acoustic neuroma.
- If there are no symptoms, your tumor is very small (3-4 millimeters) and does not progress in size, surgery may not be required.
Risks
- If left untreated, symptoms of hearing loss may occur and progress over time.
Stereotactic Radiosurgery/Gamma Knife
Stereotactic radiosurgery (Gamma Knife Radiosurgery) uses advanced technology to deliver focused radiation therapy to your brain tumor, sparing more healthy cells than traditional radiation therapy and eliminating the risks of a surgical procedure. Many acoustic neuroma specialists prefer stereotactic radiosurgery over traditional surgery, when possible, as an effective treatment for your tumor.
Benefits
- Stereotactic radiosurgery can be as effective as traditional surgery.
- Avoids open surgery, eliminating the associated risks.
- The risk of injuring the facial nerve or the nerve responsible for hearing is lower than open surgery.
Risks
- As is typical with radiation therapy, fatigue and headaches are potential side effects.
Surgical Removal
For some patients, particularly those with larger tumors that press on the brain stem and/or younger patients, surgical removal of acoustic neuroma is the preferred treatment option. It may be used in conjunction with stereotactic radiosurgery to achieve complete tumor removal.
Surgical removal is typically the final treatment option considered by acoustic neuroma specialists and only recommended when necessary because of the increased risks associated with the procedure. However, if your doctor has recommended surgery in your case, it is because he or she feels it is the most appropriate treatment for you and your individual condition.
The procedure involves removing a section of skull to provide the surgeon access to the tumor site. He or she will remove as much of the tumor as possible, which may only be a portion in some cases. Following removal, the section of bone will be replaced and the incision site will be closed with sutures or staples.
Benefits
- Once an acoustic neuroma is surgically removed, the tumor is unlikely to return.
- The surgeon can remove the entire tumor or just a portion of it.
- This is an effective treatment option if your tumor is large and putting pressure on your brain stem, which is an area of the body that cannot receive a lot of radiation.
- Surgery can be combined with radiation therapy to ensure all of the tumor is removed.
- The facial weakness that may occur following removal of a whole tumor typically resolves within a few months.
Risks
- As with any surgical procedure, there is a risk of infection and pain at the incision site.
- There is a risk of hearing loss due to nerve damage.
- Weakness in the face is a known side effect.
- There may be long-term problems with balance and coordination, also as a result of nerve damage.
- Headaches and/or fatigue are common following surgery.
Finding the Right Treatment for You
Your condition is unique and you deserve individualized care. The size and location of your tumor, your age, health conditions and personal preferences should all be taken into consideration when determining which treatment is most appropriate for your acoustic neuroma. Acoustic neuroma specialists know this and can work with you through this process to help you better understand your options and the consequences of each.
If you find that you still have questions about why your doctor has made a particular recommendation, why one procedure is preferred over another or any other concern you may have, write them down prior to your next appointment. Your doctor will work with you to ease your concerns before your procedure so you can be confident in your treatment choice.
