Your acoustic neuroma treatment may vary, depending on the size and growth of the acoustic neuroma, your overall health, and if you're experiencing symptoms. To treat acoustic neuroma, your doctor may suggest one or more of three potential treatment methods: monitoring, surgery or radiation therapy.
If you have a small acoustic neuroma that isn't growing or is growing slowly and causes few or no signs or symptoms, you and your doctor may decide to monitor it, especially if you're an older adult or otherwise not a good candidate for more-aggressive treatment.
Your doctor may recommend that you have regular imaging and hearing tests, usually every six to 12 months, to determine whether the tumor is growing and how quickly. If the scans show the tumor is growing or if the tumor causes progressive symptoms or other difficulties, you may need to undergo treatment.
You may need surgery to remove an acoustic neuroma. Your surgeon may use one of several techniques for removing an acoustic neuroma, depending on the size of your tumor, hearing status and other factors.
The goal of surgery is to remove the tumor, preserve the facial nerve to prevent facial paralysis and preserve hearing when possible.
Surgery for an acoustic neuroma is performed under general anesthesia and involves removing the tumor through the inner ear or through a window in your skull.
The entire tumor may not be able to be completely removed in certain cases. For example, if the tumor is too close to important parts of the brain or the facial nerve.
Sometimes, surgical removal of the tumor may worsen symptoms if the hearing, balance or facial nerves are damaged during the operation.
Complications may include:
- Leakage of cerebrospinal fluid through the wound
- Hearing loss
- Facial weakness
- Facial numbness
- Ringing in the ear
- Balance problems
- Persistent headache
- Infection of the cerebrospinal fluid (meningitis)
- Stroke or brain bleeding
Stereotactic radiosurgery. Your doctor may recommend a type of radiation therapy known as stereotactic radiosurgery if you have an acoustic neuroma, particularly if your tumor is small (less than 3 centimeters in diameter), you are an older adult or you cannot tolerate surgery for health reasons.
Stereotactic radiosurgery, such as Gamma Knife radiosurgery, uses many tiny gamma rays to deliver a precisely targeted dose of radiation to a tumor without damaging the surrounding tissue or making an incision. Using imaging scans, your doctor pinpoints the tumor and then plans where to direct the radiation beams.
The doctor attaches a lightweight head frame to your scalp, which has been numbed, to keep your head still during the procedure.
The goal of stereotactic radiosurgery is to stop the growth of a tumor, preserve the facial nerve's function and possibly preserve hearing.
It may take weeks, months or years before the effects of radiosurgery become evident. Your doctor will monitor your progress with follow-up imaging studies and hearing tests.
Risks of radiosurgery include hearing loss, ringing in the ear, facial weakness, facial numbness, balance problems and treatment failure (continued tumor growth).
Stereotactic radiotherapy. Fractionated stereotactic radiotherapy (SRT) delivers a small dose of radiation to the tumor over several sessions in an effort to curb the growth of the tumor without damaging surrounding brain tissue.
Proton beam therapy. This type of radiation therapy uses high-energy beams of positively charged particles called protons that are delivered to the affected area in targeted doses to treat tumors and minimize radiation exposure to the surrounding area.
In addition to treatment to remove or stop the growth of the tumor, your doctor may recommend supportive therapies to address symptoms or complications of an acoustic neuroma and its treatment, such as dizziness or balance problems.
Cochlear implants or other treatments may also be recommended to treat hearing loss.