Definition

An acoustic neuroma is a 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

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There are three main treatment options for an acoustic neuroma:

    
  • Careful monitoring
  • Radiation therapy
  • Microsurgical removal
  • This fact sheet focuses on microsurgical removal.

    Reasons for Procedure

        
  • Tumor is growing
  • Concern that tumor size may become life-threatening
  • Tumor is causing hearing problems or neurologic symptoms
  • A successful procedure results in complete removal of the tumor with minimal additional hearing loss.

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

        
  • Hearing loss
  • Excessive eye dryness
  • Difficulty with balance
  • Ringing in your ears—tinnitus
  • Facial weakness and numbness on the side of the tumor
  • Headaches
  • Infection
  • Bleeding
  • Leakage of cerebrospinal fluid (CSF)
  • Some factors that may increase the risk of complications include:

        
  • Smoking
  • Increased age
  • Size of the tumor
  • What to Expect

    Prior to Procedure

    Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

    Anesthesia

    General anesthesia will be used. You will be asleep.

    Description of the Procedure

    The type of procedure will depend on your condition. 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 approach is often used when you already have significant hearing loss. The mastoid bone in the 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. It makes 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 approach is used when there is a good chance that hearing may be maintained.

    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 surgery. Pain and discomfort after the procedure can be managed with medications.

    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:

        
  • Headache and head discomfort
  • Fatigue and sleepiness
  • Emotional lows
  • Lightheadedness
  • Nausea
  • Staff will help you manage these problems.

    Preventing Infection

    During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

        
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered.
  • There are also steps you can take to reduce your chance of infection, such as:

        
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
  • At Home

    When you get home, you may have to adjust your activity level while you recover. This may take 4-6 weeks. Home care will include caring for the surgical wound to prevent infection.

    MRI scans will be done regularly over the next several years. The scans will check to see if the tumor returns.

    Call Your Doctor

    It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

        
  • Signs of infection, including fever, chills, and neck stiffness
  • Worsening headache, balance problems, or hearning loss
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications you were given
  • Runny nose
  • If you think you have an emergency, call for medical help right away.