A vestibular schwannoma, often called an acoustic neuroma, is a benign primary intracranial tumor. Acoustic neuromas are understood to be caused by an overproduction of Schwann cells that press on the hearing and balance nerves in the inner ear.
Because these neuromata grow so slowly, a physician may opt for conservative treatment beginning with an observation period. In such a case, the tumor is monitored by annual MRI to monitor growth.
This route is common among patients over 70 years old. Since the growth rate of an acoustic neuroma rarely accelerates, annual observation is sufficient.
The surgery of acoustic tumors is a very specialized subset of skull base surgery in which there is much collaboration with the neuro-otology team. Specialized monitoring techniques developed and supervised by the school’s neuro-otologists have saved patients’ hearing and facial function.
Treatments for acoustic neuroma often includes surgical removal and radiotherapy. Several approuches may be performed for the removal of acoustic neuromas. Each approach has its advantages and disadvantages. Microsurgery for acoustic neuroma is the only technique that removes the tumor. Surgery is the only treatment that removes the vestibular nerves, therefore treating balance symptoms associated with tumor growth.
The University of Miami offers a minimally invasive endoscopic surgery for the treatment of acoustic neuromas. This approach is only available in specialized centers.
Radiation therapy is done in a variety of ways, but mainly by three methods: cyberknife radiosurgery or fractionated stereotactic radiotherapy, with a linear accelerator (linac), or proton therapy.
The Cyberknife uses a miniature linac machine attached to a robot arm which is guided using x-ray imaging to check the position of the patient between each treatment shot.
After radiation treatments for acoustic neuromas, it is important for a yearly MRI to be conducted for the rest of the patient’s life due to the possibility of regrowth of secondary tumors.