Acoustic Neuromas / Vestibular Schwannomas

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Surgery for Acoustic Neuromas

Before the advent of the surgical microscope, surgery for an acoustic neuroma was limited to removing the tumor, which often resulted in hearing loss or facial paralysis since it was impossible to separate the tumor from the cranial nerve. With the introduction of better imaging, it became possible to remove or reduce the size of an acoustic neuroma without destroying the nerve. Today, with advanced microsurgery and stereotactic radiosurgery techniques, it has become increasingly possible to remove or reduce an acoustic neuroma while preserving hearing and other functions.

Microsurgery:  Surgery is the preferred treatment for acoustic neuroma since it offers excellent odds of hearing preservation and can be used on a tumor of any size. The surgery to remove an acoustic neuroma is extremely delicate and may take several hours to complete. The neurosurgeon will choose from several possible approaches; the choice of approach depends on the size of the tumor, the risk of damage from the tumor pressing on critical structures, and the age and health of the patient.

Stereotactic Radiosurgery: Neurological surgeons can use stereotactic radiosurgery (highly targeted radiation beams directed at a tumor from multiple angles) to treat an acoustic neuroma in older patients who may not be able to tolerate surgery, and whose tumors are small. This is a rapidly developing technique requiring highly trained surgeons using the most sophisticated equipment – such as the Gamma Knife, CyberKnife, proton beams, and linear accelerators – that is usually only available in major medical centers.  Treatment may be given in either a single session or in multiple lower-dose sessions (known as fractionated radiosurgery). Results are not immediate – the goal is to control growth of the tumor, or reduce it substantially, over a course of months or years. There is a greater risk of hearing loss when stereotactic radiosurgery is used, but it may be the best option when traditional surgery is not recommended.

More about the Acoustic Neuroma Program

The neurosurgeons at the Weill Cornell Brain and Spine Center are fortunate to be part of the NewYork-Presbyterian Hospital team, with access to world-class surgical facilities and stereotactic radiosurgery equipment. The 2014-15 "America's Best Hospitals" ranking in US News and World Report placed NewYork-Presbyterian as the #1 hospital in New York, and our Neurology and Neurosurgery program ranks as the #1 program in New York (and #2 nationwide). Together, the NewYork-Presbyterian/Weill Cornell Medical Center team is the best choice for skull base surgery and the treatment of acoustic neuromas.

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Reviewed by: Jared Knopman, M.D.
Last reviewed/last updated: October 2017