Acoustic Neuroma: Treatment

There is no medication known to have a substantial effect on growth or to shrink acoustic neuroma tumours. There are three options:

  • conservative management or ‘wait and see’: This involves periodic monitoring with serial hearing tests and/or MRI scans. It is usually reserved for tumours of less than one centimetre in size.
  • radiation treatment may be employed when the risk of surgery is high because of other medical problems.
  • surgical removal of the tumour performed by a neuro-otologist (specialist in hearing and nervous system disorders) and a neurosurgeon. Surgery is the preferred treatment option in most cases and may also allow preservation of hearing.

Risks involved in treatment

All forms of treatment carry some risks. As the facial nerve, which controls the muscles of the side of the face, usually runs across the tumour there can be a high risk of facial nerve damage from surgery. This can lead to paralysis of one side of the face.

Removal of the tumour might interfere with balance, leading to ‘vertigo’ – an unpleasant feeling of unsteadiness. Because the tumour is in an awkward place with other important brain structures immediately around it there are risks of damage for example to the nerves controlling eye movement and swallowing.

The risk to a person’s hearing varies slightly with the surgical approach and the technical problems in an individual person’s case, but complete loss of hearing on the affected side is a real risk that needs to be considered.

These risks diminish when the surgical team has a high level of experience in operating on acoustic neuroma, but they should be fully discussed in advance with the patient.

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