Surgical Procedures and Radiation Therapy Options for Acoustic Neuroma

An acoustic neuroma refers to the noncancerous growth that develops on the vestibulocochlear nerve. This is also called the eighth cranial nerve and it connects the inner ear with the brain. These tumors typically grow slowly over a period of years, which is why your ENT doctor generally observes the condition at first to ascertain the best course of treatment.

However, the treatment may be necessary eventually because the tumor can grow and push on the brain. As the tumor becomes bigger, it can press on the nearby cranial nerves which control the muscles for facial expression and sensation. If the tumor becomes large enough, it can press on the brain stem and this can be life-threatening.

Surgery

The ENT doctor can recommend surgery, which may involve removing all or part of the tumor. Removing the acoustic neuroma may be undertaken using any of the 3 main surgical approaches.

Translabyrinthine

This surgical procedure has the surgeon making an incision behind the ear and then removing the bone behind the ear and some of the middle ear. This procedure is used for tumors when they grow larger than 3 centimeters.

The advantage of this technique is that it lets the facial nerve clearly before the removal of the tumor. However, the drawback of this approach is that the patient ends up with permanent hearing loss.

Retrosigmoid / Sub-occipital

This involves opening the skull near the back of the head to expose the back of the tumor. This technique can be used for removing tumors of any size and it also offers the chance of preserving hearing.

Middle Fossa

In this procedure, the surgeon removes a small piece of bone above the ear canal to reach and remove the small tumors confined to the internal auditory canal. This canal is the narrow passageway from the brain to the middle and inner ear. Using this procedure may enable the surgeon to preserve the patient’s hearing as well.

Radiation Therapy

In some cases, the ENT doctor may recommend radiation therapy for the acoustic neuroma. The doctor can deliver high doses of radiation to the tumor while limiting the exposure and damage to surrounding tissue using advanced modern delivery techniques.

Radiation therapy for acoustic neuroma can be delivered in one of two ways.

SRS (Single Fraction Stereotactic Radiosurgery)

In SRS, the doctor aims many hundreds of small beams of radiation at the tumor in just a single session.

FRS (Multi-Session Fractionated Stereotactic Radiotherapy)

The ENT doctor delivers smaller doses of radiation daily, usually over a period of several weeks. Some studies indicate that multi-session therapy may be better at preserving the hearing than SRS.

Both ways are outpatient procedures, with patients not required to stay at the hospital. The radiation therapy kills the tumor cells and the growth of the tumor may stop or slow down. It may even shrink, but the tumor isn’t completely removed.

If you suffer acoustic neuroma, it is suggested to consult an ENT Specialist for details of the treatment.

Source:

HK ENT Specialist Ltd.

Hong Kong based ENT clinic centre

For ENT Services, Audiology & Speech Therapy,

Sleep Disordered Breathing Management,

Hearing Aid Prescription & Medical Cosmetic Services

https://www.hkentspecialist.hk