Acoustic Neuroma

Acoustic neuroma (sometimes called vestibular schwannoma, a synonym) is a benign, usually slow growing tumour, which arises from part of the VIIIth cranial nerve, the nerve which is responsible for hearing and balance - a common symptom of this tumour is gradual hearing loss. Acoustic neuromas can occasionally occur on both sides, this feature being characteristic of patients who have the genetic condition known as Neurofibromatosis type 2 (NF 2).

Acoustic neuromas can present with the following symptoms:

Hearing loss

Tinnitus (ringing in the ears)

Vertigo or balance problems

Aims of Treatment:

Prevention of tumour growth (by gamma knife)

Preservation of useful hearing

Preservation of facial nerve function

Removal of tumour (by surgical excision)

Surgery

Surgery was for a long time considered to be the standard treatment for these tumours. However, the operation is a very major one, and carries a small but significant risk of major complications or even death. The patient will almost certainly be completely deaf following operation, and may have weakness of the facial muscles on the affected side because of the close proximity of the facial nerve to the site of operation. In addition there is a long recovery time and the patient can expect to be off work for many weeks. It does however offer the prospect of immediate and complete removal of the tumour. Nevertheless these tumours sometimes recur following surgery, although for tumours that are too large for Gamma Knife, surgery is still the best option.

Gamma knife

Acoustic neuromas are generally well controlled with gamma knife treatment, the usually quoted success rate being in excess of 95%. The aim is to prevent tumour growth, and this treatment is particularly well suited for tumours up to 3cm in diameter where useful hearing is still present. The risk of facial nerve damage is low, perhaps about 1%. The treatment is carried out over the course of less than a day, patients are usually back home within 24 hours (often the same day), and back at work within a few days.