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There are several options in the treatment of an acoustic neuroma.
The choice of treatment will be discussed with your neurosurgeon, usually in conjunction with an ENT (ear nose and throat) surgeon.
The procedure is performed under general anaesthetic. An “S” shaped cut is made behind the ear on the relevant side after that area has been prepared with antiseptic solution and then draped. The bone is removed and access is gained to the tumour coming around the side of the brain. A microscope is then used.
The tumour is then removed in a ‘piece-meal’ fashion and in doing so, all attempts are made to identify the cranial nerves in the area. Those below the tumour are the 9th, 10th and 11th cranial nerves and those intimately related to the tumour are the 7th and 8th, and the nerve above it is the 5th. Often a facial nerve stimulator will be used to identify the 7th cranial nerve. The bone may be replaced or cement may be used to cover the opening, and the wound is then sewn up.
The procedure is performed under a general anaethetic by a neurosurgeon and an ear, nose and throat (ENT) surgeon. The approach is performed by the ENT surgeon and irreversibly causes loss of hearing, thus being unsuitable in cases where hearing is preserved. The neurosurgeon then removes the tumour using a microsurgical technique in conjunction with the ENT surgeon.
The major advantages of this approach over the retro-sigmoid approach is early identification of the facial nerve and preservation of this nerve, less retraction of the cerebellum and greater access to the intracanicular aspect of the tumour.
The risks of this operation includes the following. A detailed discussion with your surgeon is recommended prior to surgery.
For more information on St Vincent's Neuroscience services and additional resources visit our dedicated Neuroscience site here.