There are three ways to treat acoustic neuromas — observation, radiation and surgery.
At least 10% of acoustic neuromas do not show signs of growth after they are found. Since the tumor is very slow-growing and benign, having a follow-up MRI scan and an audiogram in 6 and 12 months is a safe alternative to immediate intervention. If no changes are found, yearly checkups afterward are adequate to monitor the tumor. If the tumor does not show signs of growth, intervention is not necessary. The risk of this approach is that further permanent hearing loss can occur during this observation period.
If the tumor shows signs of growth or is pressing on the brainstem, radiation or surgery are necessary. The choice between the two depends upon a lot of factors best discussed with your surgeon and radiation oncologist. Factors such as size and location of the tumor, related health issues, age, and hearing loss all need to be considered.
If surgery is necessary it is usually performed by a team consisting of a neurosurgeon and an otologist. The neurosurgeon removes the part of the tumor around the brain and the otologist removes the part of the tumor in the ear. Hospitalization is usually for 4–7 days after surgery. Possible complications of surgery include loss of hearing and injury to the facial nerve — the nerve that supplies motion to the face.
Radiation is an alternative to surgery. It does not remove the tumor, but many times can stop the tumor growth or cause the tumor to shrink. Radiation can be delivered in a number of different ways — gamma knife, stereotactic radiosurgery, proton beam radiation and fractionated stereotactic surgery. The choice is made after discussion with the radiation oncologist. Possible complications of radiation include loss of hearing, facial nerve injury and continued growth of the tumor.