Treatment for acoustic neuroma

This page is about treatment for acoustic neuroma. There is information about

A quick guide to what's on this page
What acoustic neuroma is
Surgery
Tumours on both sides
Side effects of surgery
Radiotherapy

Acoustic neuroma

Acoustic neuromas start from cells which cover the nerve that is involved in hearing and balance (the 8th cranial nerve). They are also called vestibular schwannomas. They often grow very slowly and can be quite large before they are found. Sometimes acoustic neuromas can grow on both sides in people with a genetic condition called neurofibromatosis type 2. Treatment depends on the size of the acoustic neuroma. Small tumours may not need immediate treatment but may be monitored with regular MRI scans.

Surgery

Surgery is the most common treatment. A brain surgeon and an ear surgeon usually work together to try to remove the tumour without affecting your hearing. But most people are partly or completely deaf on that side afterwards. Other possible side effects of surgery include permanent numbness or paralysis of part of the face, which may affect speech and swallowing. It may also make the side of your face droop or cause eye dryness or ulceration.

After surgery

Your specialist may suggest radiotherapy after your surgery if your tumour cannot be completely removed. Or your doctors may just keep a close eye on the tumour that is left with regular CT scans or MRI scans.

Targeted radiotherapy

It is possible to treat some small tumours successfully with radiosurgery or Cyberknife radiotherapy.

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Acoustic neuromas are also called vestibular schwannomas. They start from schwann cells which cover the nerve that is involved in hearing and balance (the 8th cranial nerve). Most tumours start on the balance (vestibular) part of the nerve. As it grows the tumour then presses on the hearing part of the nerve. These tumours often grow very slowly and can be quite large before they are found, especially if you have had increasing deafness that has not been looked into before.

Your care and treatment will be managed by a team who specialise in treating tumours around the base of the skull. This will include a specialist head and neck surgeon.

The treatment for acoustic neuroma depends on the size it is when diagnosed. If you have a small tumour, your specialist may recommend keeping an eye on it with regular MRI scans. If you have surgery, it is usual for a brain surgeon and an ear surgeon to work together. They will try to remove the tumour without affecting your hearing. But this is often not possible and most people are partly or completely deaf on that side after the operation.

Sometimes acoustic neuromas can grow on both sides. This happens if you have a genetic condition called neurofibromatosis type 2, which has caused the acoustic neuroma. These tumours are also treated with surgery. Unfortunately, you will almost certainly be completely deaf afterwards. Your surgery may be delayed as long as possible so that you keep your hearing as long as you can.

Surgery to the cranial nerves can cause permanent numbness or paralysis of part of the face if the facial nerve is damaged during the operation. Your surgeon will try very hard to stop this happening. But sometimes it cannot be helped. This paralysis can be very distressing for some people. It can cause

Speech that is not as clear as it was
Problems with swallowing
A droop on one side of your face (facial palsy)
Problems with dryness and ulceration of the eye on that side

Physiotherapy and electrical stimulation can sometimes help to relieve these problems.

If your tumour cannot be completely removed, your specialist may suggest radiotherapy after your surgery. Or, because it is slow growing, your doctors may just keep a close eye on the tumour that is left by giving you regular CT scans or MRI scans.

If you have a small tumour, it may be possible to treat it successfully with radiosurgery or cyberknife radiotherapy. A possible side effect of these treatments is nerve damage, which can develop 6 to 9 months later.