Acoustic Neuroma Removal
(Neurilemmoma; Vestibular Schwannoma)
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.
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There are 3 main treatment options for an acoustic neuroma:
- Careful monitoring
- Radiation therapy
- Microsurgical removal
This fact sheet focuses on microsurgical removal.
Reasons for Procedure TOP
Microsurgical removal is done when:
- The tumor is growing
- There is concern that the tumor size may become life-threatening
- The 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 TOP
Problems from the procedure are rare, but all procedures have some risk. Potential problems include:
- Hearing loss
- Excessive eye dryness
- Difficulty with balance
- Ringing in the ears—tinnitus
- Facial weakness and numbness on the side of the tumor
- Headaches
- Bleeding
Some factors that may increase the risk of complications include:
- Smoking
- Increased age
- Size of the tumor
What to Expect TOP
Prior to Procedure
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week before the procedure.
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure TOP
The type of surgical 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/Suboccipital
An opening will be made in the skull behind the ear. 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 TOP
You will spend at least 1 night in the intensive care unit for care and observation.
How Long Will It Take? TOP
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? TOP
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medicines.
Average Hospital Stay TOP
The usual length of stay is 4-7 days. Your stay may be longer if there are complications.
Post-procedure Care TOP
At the Hospital
During recovery, you may have some of the following:
- Headache and head discomfort
- Fatigue and sleepiness
- Light-headedness
- Nausea
- Emotional lows
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 TOP
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 hearing 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 medicines you were given
- Runny nose
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
Acoustic Neuroma Association
https://www.anausa.org
American Academy of Audiology
https://www.audiology.org
CANADIAN RESOURCES:
Canadian Academy of Audiology
https://canadianaudiology.ca
The College of Family Physicians of Canada
http://www.cfpc.ca
REFERENCES:
Acoustic neuroma. American Hearing Research Foundation. Available at:
...(Click grey area to select URL)
Accessed September 5, 2019.
Acoustic neuroma. VEDA website. Available at:
...(Click grey area to select URL)
September 5, 2019.
Bennett M, Haynes DS. Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am. 2007;40(3):589-609.
What is acoustic neuroma? Acoustic Neuroma Association website. Available at: https://www.anausa.org/learn-about-acoustic-neuroma/what-is-acoustic-neuroma. Accessed September 5, 2019.
6/2/2011 DynaMed Systematic Literature Surveillance https://www.dynamed.com/management/treatment-for-tobacco-use-19: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed September 2019 by
EBSCO Medical Review Board
Donald W. Buck II, MD
Last Updated: 10/20/2020