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. Due to the tumor’s location, symptoms can including 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.

Treatment Options
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 a several treatment options depending on the size and the exact location of the tumor.

• Observation, if tumor shows no growth
• Outpatient radiation treatment to stop tumor growth
• Surgery - 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:
  • Translabyrinthine approach – This is the most common approach to
    removing an acoustic neuroma and is used for the largest tumors. The approach
    enables the removal of the tumor without brain retraction, however total hearing
    loss is expected.
  • Middle fossa approach – This approach is 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 – This surgery is 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.

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

• Facial weakness or paralysis
• Spinal fluid leak
• Infection
• Hearing loss
• Dizziness
• Post-operative headache
• Brain swelling and bleeding

For more detailed, technical information on this issue, please read our please read our Acoustic Neuroma patient information sheet.