Acoustic Neuroma

Acoustic neuroma is a benign tumor located on the cranial nerve controlling hearing and balance. This nerve runs from the brain to the inner ear, near several important structures. 

Due to the tumor’s location, symptoms can include hearing loss, ringing in the ear, and balance problems. Larger tumors may cause facial numbness, headaches, and, in rare cases, a life-threatening accumulation of fluid around the brain.

The size of the tumor directly affects the difficulty of treatment and resulting complications. Small tumors are confined to the internal auditory canal, while large tumors can extend to the brain cavity and place pressure on the brainstem.

For more detailed, technical information about acoustic neuroma, please read our acoustic neuroma patient information sheet.

Treatments

UT Southwestern uses a team approach to treatment and ongoing care, with ear specialists, neurosurgeons, audiologists, and physical therapists involved in the treatment process as needed.

We offer several treatment options depending on the size and the exact location of the tumor:

  • Observation, if the tumor shows no growth
  • Outpatient radiosurgery, the use of radiation in a very precise way, to stop tumor growth
  • Surgery

Surgical Options

While the total removal of the tumor is the initial goal of any surgery, in
 some cases, a small portion of the tumor may be left on the nerve to prevent 
complications. This remnant is then monitored for future growth.

Surgical options include:

Middle fossa approach
– used on patients who have good 
hearing and a small tumor. The goal is hearing preservation, which occurs in 
approximately 60 percent of cases.
Retrosigmoid approach
– used on patients with small to 
medium tumors located mostly on the brain cavity rather than in the internal
 auditory canal. Hearing preservation is possible but not guaranteed.
Translabyrinthine approach
– most common approach to 
removing an acoustic neuroma. Used for the largest tumors, this approach 
enables the removal of the tumor without brain retraction. Total hearing 
loss is expected.

Our physicians are experienced in minimally invasive techniques that reduce brain manipulation and decrease the chances of post-operative complications. However, there are risks and possible complications with any invasive surgery.

The risks and complications include:

  • Brain swelling and bleeding
  • Change in taste
  • Dizziness
  • Facial weakness or paralysis
  • Hearing loss
  • Infection
  • Post-operative headache
  • Ringing in the ears
  • Spinal fluid leak