What is acoustic neuroma surgery?
Acoustic nerve tumor surgery is the surgical procedure used to remove a tumor from the inner ear canal. A tumor in this area can compress the cochlear nerve (the nerve of hearing) and as a result, the patient will experience hearing loss, and may suffer from tinnitus (a ringing or buzzing in the ear.) Patients with acoustic neuroma may also have problems with vertigo, vision, and balance. The surgery is performed under general anesthesia.
Why is it performed?
Surgery is used when conventional treatment has not worked and the acoustic neuroma needs to be removed. There are different techniques depending on the size of the tumor, the condition of the ear and other factors. Surgery removes the tumor but has to take into account that the facial nerve has to be preserved to avoid possible paralysis and hearing if possible.
Patients with acoustic neuroma may also have problems with vertigo.
What does it consist of?
The surgery consists of the removal of a tumor either through the inner ear or through an incision in the skull. In some cases, if the tumor is located near facial nerves, it may not be possible to remove it completely. In addition, surgical removal of the tumor can sometimes worsen symptoms if the facial, hearing and balance nerves are damaged. The operation has a very low mortality rate and has infrequent sequelae. There are some complications that may occur during the operation, such as loss of cerebrospinal fluid from the cranial cavity.
Preparation for acoustic neuroma surgery
Prior to surgery, the specialist will perform an examination of the ear. In addition, he/she may order one of the following tests:
- Audiometry (hearing test): the test consists of listening to the sounds that are directed to one of the ears at a certain time. The specialist proposes a range of sounds and asks the patient to indicate them each time he/she hears them. Each tone is repeated at different levels in order to assess the hearing level.
- Imaging tests: MRI is the best test to confirm the presence of acoustic neuroma. If an MRI is not possible, a CT scan can be performed, although it is less accurate than the MRI.
Care after surgery
The patient is discharged from the hospital 3 to 5 days after the operation with the first night in the ICU. Once the patient is at home, he/she will have to have periodic check-ups with the neurosurgery specialist to see how the operation has been completed and to perform hearing tests and imaging tests such as those mentioned above.
Alternatives to this treatment
There are other treatments that may help reduce acoustic neurioma.
- The specialist may recommend a type of radiotherapy, stereotactic radiosurgery, if the tumor is 3 centimeters or less in diameter. This method consists of administering a precisely targeted dose of gamma radiation to the tumor without damaging the surrounding tissue or making an incision. The goal is to prevent the tumor from growing further and to preserve the function of the facial nerve and hearing. This treatment may take some time until there are visible results, and imaging tests and hearing tests are performed to observe the process. This treatment may be a solution for patients who cannot undergo surgery for various reasons.
- Proton beam therapy uses positively charged particles administered to the affected area in doses to treat tumors in order to minimize exposure to the surrounding area.
- The specialist may recommend other complementary treatments such as supportive therapies to detect symptoms and complications of the pathology.