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Acoustic Neuroma Surgery in New Jersey

Neurosurgeon using digital tablet to discuss brain scan with patient
Shot of a doctor using a digital tablet to discuss a brain scan during a consultation in her office

An acoustic neuroma is a noncancerous tumor in the ear that can cause problems with hearing and balance. Patients diagnosed with acoustic neuroma may be candidates for acoustic neuroma surgery at Centers for Neurosurgery, Spine & Orthopedics (CNSO). With multiple convenient locations throughout New Jersey, the multi-specialty team at CNSO is available to provide comprehensive care for a wide range of brain, spine, and nerve conditions, including rare afflictions such as acoustic neuroma tumors. Learn more about acoustic neuroma surgery available at CNSO.

What Is an Acoustic Neuroma?

An acoustic neuroma tumor, also called a vestibular schwannoma, is a benign tumor that originates in the branches of the eighth cranial nerve. This nerve starts in the brain and leads to the inner ear, then separates into areas that affect hearing and balance. Acoustic neuromas develop from an overgrowth of Schwann cells, which wrap around and support nerve fibers.

Acoustic neuromas are noncancerous, often grow slowly over time, and typically do not spread to other areas of the body. However, they can cause bothersome symptoms that affect a patient’s daily life, especially if they grow to be larger and press on surrounding structures. There are two kinds of acoustic neuromas:

  • Unilateral acoustic neuromas: This is the most common kind of acoustic neuroma and affects only one ear.
  • Bilateral acoustic neuromas: This is the rarer kind of acoustic neuroma that affects both ears and is inherited through a genetic mutation called neurofibromatosis-2 (NF2).

Acoustic neuromas can affect people of all ages but are diagnosed most often in patients between the ages of 40 and 50. Very rarely, children and young adults can be afflicted with acoustic neuromas.

Acoustic Neuroma Signs and Symptoms

Acoustic neuromas generally grow gradually and can have symptoms that are easy to overlook or attribute to other conditions. However, some tumors grow and end up compressing the surrounding nerves or other areas, which causes more noticeable signs and symptoms. These include:

  • Gradual hearing loss on one or both sides (partial or total)
  • Inability to hear high-frequency sounds
  • Ringing in the ear, known as tinnitus
  • The feeling of fullness in the ear
  • Loss of balance or feeling unsteady
  • Dizziness or vertigo
  • Facial numbness or tingling
  • Facial spasms or twitching
  • Headache

Not every patient will experience all the signs and symptoms, and which symptoms appear often depends on the size of the tumor. These symptoms also can be caused by other health problems, so it is important for patients experiencing any concerning symptoms to speak to their healthcare provider for further testing.

Acoustic Neuroma Causes and Risk Factors

Acoustic neuromas are rare, and the exact causes are not known. However, doctors and medical researchers have identified risk factors for acoustic neuroma:

Sporadic, Unilateral Tumors

Sporadic, unilateral tumors are the most common type of acoustic neuroma, occurring in 95% of all patients. They can develop in patients of all ages but are most common in people aged 30 to 60. These tumors affect only one side of the body and are caused by sporadic gene mutations, which means they are not inherited and develop suddenly.

The reason for the sudden gene mutations is not known, but one risk factor is receiving radiation therapy in the neck or head for another cancer. This can increase the chance of developing an acoustic neuroma years later.

Genetic Bilateral Tumors

Genetic bilateral tumors grow on both sides of the body and occur in only 5% of patients with acoustic neuromas. These tumors are caused by the genetic disorder neurofibromatosis type 2, a mutation in chromosome 22 that can run in families. This mutation affects the gene responsible for producing Schwann cells, and Schwann cell overproduction is what forms acoustic neuromas.

The type of tumor the patient has will determine their symptoms and the treatment options offered to them.

Diagnosing Acoustic Neuroma

Acoustic neuromas can be difficult to diagnose because they are rare and can resemble other ear conditions. If patients present with symptoms such as hearing loss and imbalance, their doctor often will complete an ear examination and order further tests to determine a diagnosis and rule out other conditions. These include:

Hearing Tests

Since hearing loss is the chief symptom of an acoustic neuroma, one of the main ways to determine a diagnosis is a hearing test called audiometry. Audiometry directs various sounds and tones to each ear and the patient indicates every time they hear one. This test determines hearing function and the degree of hearing loss.

Imaging Scans

If the audiometry results point to an acoustic neuroma, the next step is for the patient to undergo imaging scans to locate the tumor. Both computerized tomography (CT) and magnetic resonance imaging (MRI) scans can be used to help find and measure the tumor, although MRIs are preferred because they are more sensitive than CTs.

A combination of these two methods is the best way to diagnose an acoustic neuroma.

Acoustic Neuroma Treatment Options

After receiving an acoustic neuroma diagnosis, a patient will work with their doctor to decide on the most suitable treatment option. Factors to consider include the size and location of the tumor and the age, health status, and symptoms of the patient. Unfortunately, there is no treatment to make acoustic neuromas completely disappear or reverse the effects. However, treatments for acoustic neuromas can prevent symptoms from worsening and even reduce them. These include:

Active Surveillance

Monitoring the tumor in a practice called active surveillance is an option for acoustic neuroma tumors that are small and growing very slowly. Active surveillance is essentially what it sounds like — observing the tumor regularly to look for any changes instead of undergoing immediate aggressive treatment. The surveillance process uses both imaging and hearing tests, much like the diagnostic process, to measure the growth of the tumor over time, usually every 6 months to a year.

This treatment option is best for cases where the tumor is causing mild or no symptoms, or if the patient cannot tolerate more invasive treatment options. If the surveillance shows the tumor has progressed to a certain point, then other treatment options will be considered.

Radiation Therapy

Another treatment option for acoustic neuromas is radiation therapy, which helps stop the growth of the tumor, therefore helping to preserve the facial nerve’s function and hearing abilities. This treatment option is recommended for:

  • Older adult patients
  • Patients who cannot tolerate surgery
  • Small tumors that measure less than two and a half centimeters in diameter

The most common type of radiation therapy for acoustic neuromas is stereotactic radiosurgery (SRS). Stereotactic radiosurgery is a non-invasive treatment option that uses tiny beams of radiation to target tumors precisely with a high dose of radiation. Although the radiation prevents damage to surrounding healthy cells and prevents the tumor from getting bigger, it does not make the tumor or symptoms go away.

Surgery

Surgery is the other main method for helping to treat patients with an acoustic neuroma. This surgery involves the removal of the tumor by a neurosurgeon. The goal of the surgery is to remove the tumor and decrease symptoms while preserving any hearing left and the function of the facial nerve. Surgeons use different methods to approach the tumor for removal, including:

  • Translabyrinthine (through the mastoid bone)
  • Retrosigmoid (Behind the ear)
  • Middle fossa (above the ear)

Surgery is best for tumors that are growing large and causing symptoms. However, patients need to know that acoustic neuroma surgery comes with risks of hearing and facial nerve complications, especially for larger tumors.

Centers for Neurosurgery, Spine & Orthopedics specializes in diagnosing and treating both common and rare conditions like acoustic neuromas. CNSO takes a conservative approach to pain management and treatment throughout the patient journey, which means attempting minimally invasive methods for treatment first. If these options prove ineffective for a particular patient, the comprehensive care team will work together to decide if acoustic neuroma surgery is the best alternative.

Acoustic Neuroma Surgery Recovery

The recovery from acoustic neuroma surgery is not a quick process; it happens gradually. Once the surgery is finished, the patient will be moved to a hospital room and their vitals will be monitored by the medical staff. Patients usually spend a few days in the hospital recovering and may experience post-op pain, headaches, balance issues, and even hearing damage.

Once the patient is discharged, they will be given activity limitations and pain medication to help manage their pain at home. Most patients will have regular follow-up appointments with their doctor and usually can return to work in 8 to 12 weeks.

Acoustic Neuroma Surgery at CNSO

Centers for Neurosurgery, Spine & Orthopedics is made up of a comprehensive team that includes various specialists such as neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. The CNSO team works to provide the highest quality of care to patients throughout northern New Jersey. Benefits of receiving care from CNSO include:

  • Personalized treatment plans
  • State-of-the-art equipment
  • Fluency in multiple languages
  • Surgical and non-surgical treatment options
  • Telemedicine appointments
  • Multiple locations throughout northern New Jersey in Bergen, Passaic, Essex, Hudson, and Morris counties

Request More Information About Acoustic Neuroma Surgery

Patients who notice a decrease in their hearing abilities or balance should ask their doctor about acoustic neuroma. Centers for Neurosurgery, Spine & Orthopedics offers treatments for brain, spine, and nerve conditions like acoustic neuromas to patients throughout northern New Jersey. Request an appointment today to learn more about acoustic neuroma surgery or other treatment options.

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In order to provide an accurate diagnosis with the most effective treatment option for “back problems” and brain tumors, CNSO is led by neurosurgeons and orthopedic spine surgeons. Under the care of our award-winning neurosurgeons and orthopedic spine surgeons, Northern NJ patients can have the confidence that their medical condition will be handled with consideration for their comfort and long-term well-being as well as technical excellence.

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