Acoutic Neuroma Treatment Options

An acoustic neuroma, also known as vestibular schwannoma, is a noncancerous and usually slow-growing tumor that develops on the main nerve leading from the inner ear to the brain. This nerve, the vestibulocochlear nerve, is involved in hearing and balance. Acoustic neuromas are rare and typically grow slowly over a period of years. Although they do not invade the brain, they can push against it as they grow, potentially causing serious complications.

The symptoms of acoustic neuroma are often subtle and may take years to develop. They typically arise from the tumor’s effects on hearing and balance. An acoustic neuroma can also put pressure on adjacent nerves, the brainstem, or cerebellum. Common symptoms include hearing loss, ringing in the ears, dizziness or loss of balance, facial numbness and difficulty understanding speech. Dallas Neurology and Spine offers both surgical and nonsurgical treatment options for this benign tumor.

There are three treatment options to treat acoustic neuromas


In many cases, especially for small, slow-growing tumors in older adults, the best approach might be watchful waiting. This involves regular monitoring with hearing tests and MRI scans to track the tumor’s growth. This may preserve hearing longer in some cases. Benefits include avoiding the risks of medical, surgical and radiation treatments.

Radiation Therapy

This treatment involves directing precise radiation beams at the tumor to stop its growth. It’s typically an option for smaller tumors or for patients for whom surgery is risky. There are two main types of radiation therapy:

  • Stereotactic Radiosurgery (Gamma Knifeâ): Gamma Knife is not a knife. Treatment delivers a single, high dose of radiation directly to the tumor, minimizing exposure to surrounding tissue. The goal is to destroy the tumor cells while preserving the nerves and avoiding the risks of surgery. The tumor shrinks over time. Gamma Knife surgery is an outpatient procedure.
  • Fractionated Stereotactic Radiotherapy: Delivers smaller doses of radiation over several sessions. This options is for patients who may be unable to have surgery because the tumor is too large, or they have other health conditions. This procedure involves the use of imaging to deliver targeted radiation therapy in low daily doses over several weeks

Radiation therapy can be effective at controlling tumor growth, but it also carries risks, including hearing loss, facial weakness, or, rarely, secondary cancers. Treatment side effects can include dizziness, headaches and hearing problems. Your Dallas Neurosurgeon can help you deal with side effects with medications, rehabilitation and other therapies.


Surgical removal of the tumor is often recommended for larger tumors or those causing significant symptoms such as persistent headaches, facial pain or hydrocephalus, fluid on the brain. It may also be recommended for small tumors that are fast growing. The goals of surgery are to remove the entire tumor, preserve the facial nerve to prevent facial paralysis, and preserve hearing when possible.

The type of surgical approach depends on the tumor’s size and location. Surgery is typically guided by computer software which allows the surgeon to precisely remove the tumor while preserving hearing, balance and facial movement.

However, surgery carries risks such as hearing loss, facial weakness, and balance problems. Your Dallas Neurosurgeon will work with you to recover hearing and balance with rehabilitation.

Hearing and balance rehabilitation after surgery for acoustic neuroma is an essential component of postoperative care. These rehabilitative processes aim to help patients adapt to changes in hearing and balance that may result from the surgery. Given the complexity of these functions and the potential impact on quality of life, a multidisciplinary approach is often employed, involving audiologists, vestibular therapists, and sometimes, psychologists.

The choice of treatment is complex and depends on various factors. Small, asymptomatic tumors may only require observation, while larger, symptomatic tumors may necessitate active treatment. The patient’s age, overall health, and personal preferences also play significant roles in this decision.

The neurosurgeons at Dallas Neurosurgical & Spine are trained in treating both spine and brain conditions using minimally invasive techniques, complex spinal reconstruction methods, as well as state-of-the-art tools such as the Gamma Knife®. The list of neurosurgical treatments offered through Dallas Neurosurgical & Spine spans the full range of treatment options. Contact us to schedule a consultation to receive the correct diagnosis and all your treatment options.

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