What is an acoustic neuroma?

An acoustic neuroma is a noncancerous (benign) growth (tumor) of the balance (vestibular) nerve in the internal auditory canal. They typically grow slowly, but eventually are large enough to press on the hearing nerve and cause hearing loss, sometimes including ear noise (tinnitus). Approximately 2 in 100,000 people have an acoustic neuroma. They are the most common tumor of the inner ear and surrounding tissue.  

People with an acoustic neuroma might experience:

  • Fullness
  • Pressure
  • Aching behind or in the ear
  • Balance problems
  • Dizziness
  • Muscle weakness on one side of the face

If you are experiencing symptoms associated with acoustic neuroma, your Summit Health neurotologist can use a sensitive test to identify tumors as small as 1 millimeter. He also will examine you and perform a hearing test. If the results of your hearing test show a difference in hearing between your right and left ears, you will have a magnetic resonance image (mri) of the neuroma brain and hearing nerve to determine whether you have a tumor.

Treatment for acoustic neuroma

Treatment for acoustic neuroma can involve microsurgery, stereotactic radiation therapy, a wait-and-watch approach, or skull base surgical procedures. Surgeons at the Summit Health ear specialty center are highly skilled in all surgical and nonsurgical approaches for acoustic neuroma, including:

  • Middle cranial fossa surgery
  • Retrosigmoid/suboccipital surgery
  • Translabyrinthine surgery

If you have an acoustic neuroma, your surgery will depend on: 

  • Your wishes
  • Hearing level
  • Other neurological symptoms
  • The location and size of the tumor

Your surgeon will thoroughly discuss your desires, expectations, and concerns as well as limits and risks of the surgery. He also will review your medical history and recommend option(s) that would be suitable for you.

Hospital stay after microsurgery is typically 4 to 7 days. Most patients need 6 to 12 weeks to fully recover from the procedure. Your surgeon will provide details about your surgery as well as suggest what to do and expect before and after the procedure.

Stereotactic radiation therapy (radiosurgery)

Stereotactic radiation therapy (radiosurgery) involves delivering either a single or fractionated (a series of 3 to 5 doses) high-dose of radiation to shrink the tumor or stop it from growing, while preserving surrounding nerves and brain tissue. Although this approach does not remove the tumor, it often prevents further tumor growth and is a viable nonsurgical option for some patients. Patients who have stereotactic radiation therapy must have follow-up imaging to ensure the tumor is no longer growing.

Radiosurgery is typically an outpatient procedure and requires little down time.

Skull base surgery

Other skull base surgery approaches are used to treat skull base tumors, including:

  • Glomus jugulare
  • Other jugular foramen tumorsera
  • Petroclival meningiomas
  • Chordomas 
  • Epidermoid tumors 

Skull base approaches can also be used in complex neurovascular aneurysm surgery.

Depending on the size and location of the tumor as well as symptoms, it is sometimes best to postpone surgery and monitor tumor growth. If you have a skull base tumor, your neurotologist will discuss all appropriate options and partner with you in determining the treatment approach that is best for you.

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