Acoustic Neuroma Treatment

Because they are uncommon and complex, acoustic neuromas demand attention from a highly experienced and skilled group of specialists.

The physicians and other professionals at MD Anderson have an unmatched level of experience and expertise in diagnosing and treating acoustic neuroma. We offer exceptional multidisciplinary, comprehensive care that includes audiology, physical therapy and related services.

If you are diagnosed with acoustic neuroma, your doctor will discuss the best options to treat it. This depends on several factors, including:

• The size and location of the tumor
• Your age
• Your general health
• Your hearing
• Your treatment preferences

Goals and expectations

Most patients with acoustic neuromas want their tumor to disappear, their hearing and balance to be restored, and their tinnitus to stop. Unfortunately, these expectations are beyond the reach of current technology. There is no drug or chemotherapy that makes these tumors disappear or treatment that can completely reverse their impact.

Surgery can remove these tumors, but it does not restore the hearing that has been lost or stop the tinnitus. Stereotactic radiosurgery can stop these tumors from growing, but it does not prevent hearing loss or eliminate tinnitus.

These treatments can, however, stop symptoms from getting worse and allow patients to begin therapies that may reduce a tumor’s impact.

Your acoustic neuroma treatment will be customized to your needs. One or more of the following therapies may be recommended.

Surgery

Surgery to remove the tumor is a common treatment for acoustic neuroma.

Like all surgeries, acoustic neuroma surgery is most successful when performed by a team of specialists with a great deal of experience and surgical skill. MD Anderson’s surgeons are among the most experienced in the world in surgery to treat acoustic neuromas.

Surgery for acoustic neuromas is complex and delicate, and it requires a team of experts from several specialties.

Surgical approaches include:

• Through the mastoid bone (translabyrinthine)
• Behind the ear (retrosigmoid)
• Above the ear (middle fossa)

Your physician will recommend the best type of surgery for your specific condition. Approaches that can preserve hearing are available for some carefully selected patients most likely to benefit from these procedures.

Stereotactic radiosurgery

Stereotactic radiosurgery (SRS) is a non-invasive treatment that uses dozens of tiny radiation beams to accurately target tumors with a single high dose of radiation. Despite its name, SRS is not a surgical procedure. It does not require an incision or general anesthesia. 

For the one-day procedure, the patient is fitted with a headframe by a neurosurgeon, and a special MRI scan is performed. Then the care team creates a customized treatment plan. The patient is placed in the stereotactic radiosurgery machine, which has a sophisticated and highly accurate patient positioning system (PPS). The patient's head is inserted into a cone-shaped cylinder, while an audio/visual connection allows the patient to communicate with and be seen by the treatment team.

The cylinder delivers highly focused gamma rays to the tumor. The contribution of each ray is relatively small, allowing for less damage to surrounding healthy cells. When the multiple rays converge on the tumor, they have great intensity.

Learn more about stereotactic radiosurgery.

Active surveillance

Sometimes called watchful waiting, this approach may be used for some patients with small or slow-growing acoustic neuromas. Instead of undergoing immediate treatment, the patient undergoes regular monitoring for tumor growth and progression. Treatment will begin only if the disease progresses to a set point.

For acoustic neuroma, active surveillance includes regular MRI exams to track tumor growth and audiograms to monitor hearing status.