Acoustic Neuroma Removal
(Neurilemmoma; Vestibular Schwannoma)
DefinitionAn 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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- Careful monitoring
- Radiation therapy
- Microsurgical removal
Reasons for ProcedureMicrosurgical remove 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
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Potential problems include:
- Hearing loss
- Excessive eye dryness
- Difficulty with balance
- Ringing in your ears
- Facial weakness and numbness on the side of the tumor
- Increased age
- Size of the tumor
What to Expect
Prior to ProcedureTalk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
AnesthesiaGeneral anesthesia will be used. You will be asleep.
Description of the ProcedureThe 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:TranslabyrinthineThis 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-occipitalAn opening will be made in the skull behind the ear. It makes it easier to see and protect the nerves during surgery.Middle FossaThe 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 ProcedureYou 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 StayThe usual length of stay is 4-7 days. Your stay may be longer if there are complications.
Post-procedure CareAt the HospitalDuring recovery, you may have some of the following:
- Headache and head discomfort
- Fatigue and sleepiness
- Emotional lows
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- 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
Call Your DoctorIt 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 medications you were given
- Runny nose
Acoustic Neuroma Association
American Academy of Audiology
Canadian Academy of Audiology
The College of Family Physicians of Canada
Acoustic neuroma. American Hearing Research Foundation. Available at: http://american-hearing.org/disorders/acoustic-neuroma. Updated October 2012. Accessed August 8, 2014.
Acoustic neuroma. Vestibular Disorders Association. Available at: http://vestibular.org/acoustic-neuroma. Accessed August 8, 2014.
Bennett M, Haynes DS. Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am. 2007;40(3):589-609.
Vestibular schwannoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 21, 2014. Accessed August 8, 2014.
What is acoustic neuroma? Acoustic Neuroma Association website. Available at: http://www.anausa.org/index.php/overview/what-is-acoustic-neuroma. Accessed August 8, 2014.
6/2/2011 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed. 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.e8.
- Reviewer: Michael Woods, MD
- Review Date: 08/2014
- Update Date: 08/08/2014