Acoustic Neuroma
An acoustic neuroma - also known as a vestibular schwannoma - is a tumor that arises from a nerve within the skull that supports hearing and balance. Acoustic neuromas are nerve tumors - not brain tumors - and are very rarely cancerous (roughly 1-2 per 100,000), but they can cause problems as they grow. Common symptoms include hearing loss on one side, vertigo, balance problems, and tinnitus (ringing in the ears). An acoustic neuroma is usually diagnosed with a brain MRI.
MRI scan of a patient with an acoustic neuroma.
Acoustic neuromas tend to be slow-growing tumors, usually no more than 1-2 mm per year. Small tumors can sometimes just be watched with periodic MRI scans, but many need to be treated at some point as they become larger and cause more symptoms. Treatment consists of radiosurgery (e.g. Gamma Knife), open surgical removal, or a combination of the two.
Gamma Knife is an excellent treatment option for most acoustic neuromas. A focused dose of radiation is delivered to the tumor, usually in a single session. The procedure is painless and does not require an incision or hospital stay. Gamma Knife has a high rate of tumor control (85-98% over 10 years) and a favorable side effect profile versus open surgical removal.
Surgical removal is performed by a team of a neurosurgeon and a neuro-otologist (a specialized ENT doctor) using one of several approaches. Surgery is more definitive than Gamma Knife, but it carries more risks and has a longer recovery period. Deciding between these two therapies requires a detailed discussion between you and your doctor.
If you live near Denver and have an acoustic neuroma, please consider meeting me in consultation to learn about treatment options.
