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Neurology (Expert Forum)
Re: acoustic neuroma
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Re: acoustic neuroma
by CCF NEUROSURGERY MD, Jan 01, 1995 12:00AM
Posted By CCF NEUROSURGERY MD on August 25, 1997 at 11:02:13:
In Reply to: acoustic neuroma posted by Paul Hyde on August 24, 1997 at 12:50:39:
: Having recently been diagnosed with a "medium sized" acoustic neuroma in my right ear, I have researched as much data as I can. The result has been somewhat confusing to me as to the best treatment approach I should pursue. Microsurgery offers 1) middle fossa, 2) suboccipital, 3) translabyrinthine surgery, and 4) stereotactic radiosurgery. Of course the radiosurgery appeals to me personally because it is not intrusive, but there is not a lot of literature encouraging it. What are the most important determining factors in guiding my decision for treatment from these four approaches?
Thank you for your time and this wonderful public service you provide.
Paul (age 60)
__
Dear Paul,
Acoustic neuromas are benign tumors of the vestibular portion of the acoustic,
or eighth cranial nerve. They generally present with a history of progressive
hearing loss or tinnitus on the affected side. A larger tumor may cause vertigo
and ataxia(unsteadiness with gait)as well as facial weakness. The natural
history is for the tumor to slowly grow larger and cause mass effect on local
structures.
You have a few options. As you mentioned, there are three different surgical
approaches to these tumors. The selection of the correct surgical approach
depends on two factors: the size and particular anatomy of the tumor, and the
degree of hearing loss on the affected side. You probably have already had
an MRI and an audiogram. Key information is provided by these exams. For
example, the translabyrinthine approach will sacrifice hearing on the affected
side. Clearly one would not want to sacrifice functional hearing if it could
be avoided.
Besides formal surgery, other options include radiation and observation alone.
The Cleveland Clinic now offers the Gamma Knife for radiosurgery, and it
has been used successfully for acoustic neuromas. The options above need
to be discussed in light of MRI and audiogram results, not to mention your
age and general medical condition.
The Cleveland Clinic would be happy to see you for a second opinion should
you so desire. You should bring MRI's and copies of your medical charts if
you choose to be seen in consultation. The Department of Neurosurgery may
be reached at 216-444-5672.
Good luck.
In Reply to: acoustic neuroma posted by Paul Hyde on August 24, 1997 at 12:50:39:
: Having recently been diagnosed with a "medium sized" acoustic neuroma in my right ear, I have researched as much data as I can. The result has been somewhat confusing to me as to the best treatment approach I should pursue. Microsurgery offers 1) middle fossa, 2) suboccipital, 3) translabyrinthine surgery, and 4) stereotactic radiosurgery. Of course the radiosurgery appeals to me personally because it is not intrusive, but there is not a lot of literature encouraging it. What are the most important determining factors in guiding my decision for treatment from these four approaches?
Thank you for your time and this wonderful public service you provide.
Paul (age 60)
__
Dear Paul,
Acoustic neuromas are benign tumors of the vestibular portion of the acoustic,
or eighth cranial nerve. They generally present with a history of progressive
hearing loss or tinnitus on the affected side. A larger tumor may cause vertigo
and ataxia(unsteadiness with gait)as well as facial weakness. The natural
history is for the tumor to slowly grow larger and cause mass effect on local
structures.
You have a few options. As you mentioned, there are three different surgical
approaches to these tumors. The selection of the correct surgical approach
depends on two factors: the size and particular anatomy of the tumor, and the
degree of hearing loss on the affected side. You probably have already had
an MRI and an audiogram. Key information is provided by these exams. For
example, the translabyrinthine approach will sacrifice hearing on the affected
side. Clearly one would not want to sacrifice functional hearing if it could
be avoided.
Besides formal surgery, other options include radiation and observation alone.
The Cleveland Clinic now offers the Gamma Knife for radiosurgery, and it
has been used successfully for acoustic neuromas. The options above need
to be discussed in light of MRI and audiogram results, not to mention your
age and general medical condition.
The Cleveland Clinic would be happy to see you for a second opinion should
you so desire. You should bring MRI's and copies of your medical charts if
you choose to be seen in consultation. The Department of Neurosurgery may
be reached at 216-444-5672.
Good luck.
