An acoustic neuroma is a noncancerous tumor that grows in the inner ear. It pops up on the eighth cranial nerve and tends to grow extremely slowly. Because of this, the treatment options for this type of tumor differ from those of cancerous ones.
An acoustic neuroma is benign, also known as non-cancerous. The major symptoms of acoustic neuroma range from hearing loss and tinnitus (a ringing in the ears) to headaches and dizziness. The more the tumor grows, the more likely it is to cause symptoms like walking with an unsteady gate and having trouble swallowing.
At this stage, the tumor will need to be treated. Let’s go over the three main treatment options here.
Doing Nothing
The very first treatment usually involved doing nothing but observing the tumor. Scans and MRIs will be conducted on a regular basis, normally once a year during the very early stages to quarterly or monthly during the middle ones. Why is this the first treatment option? There are several reasons for this. The first is that these types of tumors tend to grow extremely slowly – so slowly that the initial symptoms may take years to worsen.
On top of this, brain surgery of any kind is extremely risky. There’s no need to undergo this type of brain surgery for a very tiny tumor that could take a decade or more to grow to a dangerous size. Since an acoustic neuroma isn’t cancerous, there is little reason to do undergo a risky surgery until it absolutely needs to be done.
There are no worries about the tumor spreading to other parts of the body and causing additional problems, so most specialists just watch and wait. This is generally called the “observation” phase of treatment, and it can go on for years.
Surgical Options
Once the tumor begins to grow and cause additional symptoms to pop up, it’s time to consider surgery. There are three main surgical options that your specialist will discuss with you. The first is called the retrosigmoid. This type of surgery is true brain surgery.
The back of your head, on the side where the tumor is located, will be opened up so that the surgeon can access the area. No matter the size of the tumor, this is an option. The best thing about the retrosigmoid surgery is that fact that you might regain your hearing in that ear.
Of course, this depends on the size of the tumor and the skill of the surgeon, but it’s a definite possibility. The downside is the recovery time. Since part of the skull is removed, you’ll need more time to bounce back.
The second surgical option is called translabyrinthine. When this type of surgery is performed, the skull isn’t opened, so it’s much less radical than the first. In order for a translabyrinthine surgery to be done, the tumor must be at least three centimeters in diameter. The surgeon will make an incision immediately behind the affected ear, below the skull, and then will remove the middle ear, as well as the piece of bone that resides there.
While this technique exposes the facial nerve, helping the surgeon to determine that they’ve removed all traces of the tumor in that area, you’ll have permanent hearing loss in that ear.
Next, is a type of surgery called middle fossa. This involves going in through the ear and taking out a piece of the bone that is located above the ear canal. Very small acoustic neuromas can be removed this way, and as long as they are solely in the auditory canal (in other words, your ear canal), no trace of them will be left.
Thankfully, this type of surgery won’t harm your hearing. While you might hear a little bit less out of that ear and have some lingering damage, you won’t have permanent hearing loss there.
Radiation Options
The final treatment option for an acoustic neuroma involves radiation. Even though the tumor isn’t cancerous, this is a valid treatment, as it can shrink the tumor down to practically nothing. You might undergo one of two different types of radiation treatment. The first involves undergoing a single session of radiation where a number of targeted beams are sent directly to the tumor in order to kill it and stop it from growing.
The downside is that you might end up with hearing loss in that ear, even once the tumor shrinks. The other involves going for multiple radiation sessions. You’ll receive the same targeted radiation, but the intensity will be lower. This type will help preserve as much of your hearing as possible.
As you can see, there are three main treatment options for acoustic neuroma. They involve watching and waiting, having surgery, and finally, undergoing radiation. The latter two have high rates of success.
