Acoustic Neuroma Removal Overview

An acoustic neuroma is a benign (noncancerous) tumor. It grows on the acoustic nerve, which runs from the brain to the ear. This type of tumor typically grows slowly. It may cause hearing loss, balance problems, facial numbness, and headaches.

The Acoustic Nerve © 2009 Nucleus Medical Media, Inc.

There are three main treatment options for an acoustic neuroma:

• Careful monitoring
• Radiation therapy
• Microsurgical removal

This fact sheet focuses on microsurgical removal.

Prior to Procedure

The following medicines may be given before the procedure:

• Steroids—usually started 48 hours before surgery
• Antibiotic—given by IV (into the vein) right before surgery

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

The type of procedure will depend on your case. Factors such as hearing status and the size and location of the tumor will be considered. One of the following surgical methods will be selected:

Translabyrinthine

This is often used when you already have significant hearing loss. The mastoid bone (part of skull) and bone in the inner ear will be removed. This allows access to the ear canal and the tumor.

Retrosigmoid/Sub-occipital

An opening will be made in the skull behind the ear. This approach is used for large or small tumors. This process will make it easier to see and protect the nerves during surgery.

Middle Fossa

The tumor will be removed from the upper surface of the ear canal. This is used when there is a good chance that hearing may be preserved.

Immediately After Procedure

You will spend at least one night in the intensive care unit for care and observation.

How Long Will It Take?

The surgery takes about 6-12 hours. The exact length will depend on the size and location of the tumor.

How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. You may notice pain after the procedure. Talk to your doctor about medicines to help manage the pain.

Average Hospital Stay

The usual length of stay is 4-7 days. Your stay may be longer if there are complications.

Post-procedure Care

At the Hospital

During recovery, you may have some of the following:

• Head discomfort
• Fatigue and sleepiness
• Emotional lows
• Headache
• Dizziness
• Nausea

Staff will help you manage these problems.

At Home

Be sure to follow your doctor’s instructions. They may include:

• Keep the incision area clean and dry.
• Do not drive until your doctor allows it.
• Ask your doctor when you will be able to return to work.
• Take medicines as instructed.

Full recovery typically takes 4-6 weeks. MRI scans will be done regularly over the next several years. The scans will check to see if the tumor returns.

RESOURCES:

American Hearing Research Foundation
http://www.american-hearing.org/

National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov/

CANADIAN RESOURCES:

The Canadian Hearing Society
http://www.chs.ca/

Canadian Society of Otolaryngology
http://www.entcanada.org/

References:

Acoustic Neuroma Association website. Available at: http://anausa.org/ .

Bennett M, Haynes DS. Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am. 2007;40(3):589-609.

International Radiosurgery Association website. Available at: http://www.irsa.org/ .