What are the best treatments for Vestibular Schwannoma-Acoustic neuroma?

Treatments for Vestibular Schwannoma-Acoustic neuroma

Vestibular Schwannoma, also known as Acoustic neuroma, is a benign tumor that develops on the nerve responsible for balance and hearing. While these tumors are non-cancerous, they can cause significant symptoms and complications if left untreated. The treatment approach for Vestibular Schwannoma depends on various factors such as tumor size, location, and the patient's overall health. Here are some of the best treatment options available:

1. Observation

In cases where the tumor is small and not causing significant symptoms, a "wait and watch" approach may be recommended. This involves regular monitoring of the tumor's growth through imaging tests such as MRI. Observation is often suitable for elderly patients or those with underlying health conditions that make surgery or radiation risky.

2. Surgery

Surgical removal is a common treatment option for larger tumors or those causing severe symptoms. The goal of surgery is to completely remove the tumor while preserving the facial nerve and hearing function. There are different surgical techniques available, including:

• Translabyrinthine approach: This approach involves removing the mastoid bone and the inner ear to access and remove the tumor. It is typically used when hearing preservation is not a concern.


• Retrosigmoid approach: This technique involves removing a small portion of the skull behind the ear to access the tumor. It allows for better preservation of hearing and facial nerve function.


• Middle fossa approach: This approach is used for smaller tumors located near the internal auditory canal. It involves making an incision above the ear and removing a small piece of bone to access and remove the tumor.

Surgery carries risks, including potential damage to the facial nerve, hearing loss, and other complications. The choice of surgical approach depends on the tumor's characteristics and the surgeon's expertise.

3. Radiation Therapy

Radiation therapy is an alternative treatment option for patients who are not suitable candidates for surgery or prefer a non-invasive approach. It involves using high-energy beams to target and destroy the tumor cells. There are different types of radiation therapy used for Vestibular Schwannoma:

• Stereotactic radiosurgery (SRS): This technique delivers a highly focused radiation dose to the tumor while minimizing exposure to surrounding healthy tissues. It is typically a one-time treatment.


• Fractionated stereotactic radiotherapy (FSRT): FSRT delivers radiation in smaller doses over multiple sessions, usually spread over several weeks.

Radiation therapy is effective in controlling tumor growth and preserving hearing in some cases. However, it may take months to years for the tumor to shrink, and there is a risk of long-term complications such as hearing loss, facial numbness, or radiation-induced tumors.

4. Hearing Rehabilitation

For patients who experience hearing loss due to Vestibular Schwannoma, hearing rehabilitation can significantly improve their quality of life. This may involve the use of hearing aids, assistive listening devices, or cochlear implants, depending on the severity of hearing impairment.

5. Follow-up Care

Regardless of the treatment option chosen, regular follow-up care is essential for patients with Vestibular Schwannoma. This includes periodic imaging tests to monitor tumor growth and assess treatment effectiveness. Additionally, ongoing evaluation of hearing function and management of any associated symptoms are crucial.

It is important to consult with a team of healthcare professionals, including neurosurgeons, radiation oncologists, and audiologists, to determine the most appropriate treatment plan for Vestibular Schwannoma. The choice of treatment depends on individual factors and should be tailored to each patient's specific needs and preferences.