Acoustic Neuroma Removal (Neurilemmoma, Vestibular Schwannoma)

Translabyrinthinethe doctor removes the mastoid bone and bone in the inner ear for access to the ear canal and the tumor. This approach is often used when hearing is already minimal.Retrosigmoid/Sub-occipitalan incision is made through an opening in the skull, behind the mastoid part of the ear. This approach is used for large or small tumors, and makes it easier for the surgeon to view the facial nerve and to save the hearing.Middle fossaThe tumor is removed from the upper surface of the internal ear canal beyond the inner ear. This approach is used when there is a good chance that hearing may be preserved. After Procedure You will spend at least one night in the intensive care unit for care and observation. During recovery, you may experience some of the following: Head discomfortFatigue and sleepinessEmotional "lows"HeadacheDizzinessNausea How Long Will It Take?The surgery takes about 6-12 hours. The exact length will depend on the size and location of the tumor. Will It Hurt?Anesthesia will prevent pain during the procedure. Possible Complications Side effects may be temporary or permanent. They include: Hearing lossExcessive eye drynessDifficulty with balanceTinnitusFacial weakness and numbness on the side of the tumorHeadachesCerebrospinal fluid leak. This may present as clear fluid leakage from the nose, or fluid collecting under the incision. Average Hospital StayRecovery time in the hospital will take 4-7 days.

Postoperative CareFull recovery typically takes 4-6 weeks. Outcome Successful completion of the surgery results in complete removal of the tumor, and minimal additional hearing loss. You should have MRI scans regularly over the next several years to check for recurrence. Call Your Doctor If Any of the Following OccursSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge at the incision siteCough, shortness of breath, chest pain, or severe nausea or vomitingNeck stiffnessRunny nose RESOURCES: American Hearing Research Foundationhttp://www.american-hearing.org/index.jsp National Institute on Deafness and Other Communication Disordershttp://www.nidcd.nih.gov CANADIAN RESOURCES: The Canadian Hearing Societyhttp://www.chs.ca/ Canadian Society of Otolaryngologyhttp://www.entcanada.org/default.asp References: Acoustic Neuroma Association website. Available at: http://anausa.org/ . International Radiosurgery Association website. Available at: http://www.irsa.org/ . Last reviewed March 2008 by Elie Rebeiz, MD, FACSPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.