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	Related conditions   - Acoustic neuroma   - Alzheimer's disease   - Stroke   - Carpal tunnel syndrome   - Trigeminal neuralgia   - Epilepsy   - Whiplash   - Hydrocephalus   - Restless leg syndrome   - Multiple sclerosis   - Dementia   - Parkinson's disease   - Vertebral fracture   - Peripheral neuropathy

Treatment for acoustic neuroma

Treatment options include observation, which may be appropriate in some cases, surgery or radiation. The physician will go over all possible treatment options with the patient and recommend which is most appropriate. 

Observation may be appropriate when the tumor is small, noted incidentally, or if the patient is medically too unstable from another cause to undergo intervention. Observation will usually involve serial MRI examinations at scheduled points in the future. In some cases where the patient has usable hearing in the affected ear, observation is appropriate to extend the ability to hear from the affected ear.

Surgical intervention is recommended for total removal of the lesion. This involves a craniotomy where a portion of the skull is removed to allow access to the brain and is then returned to position afterwards. This is also the only approach where the tissue can be examined and a definitive determination made as to its tissue type. 

The surgery is done with an operating microscope, which aids in identification of surrounding structures. In some cases, hearing may be preserved; in many patients, hearing loss is so severe before surgery that it cannot be preserved. The postoperative course involves 24-36 hours in the intensive care unit and about five days in the hospital.

Stereotactic radiosurgery with the gamma knife is used for patients who do not wish to undergo a craniotomy and for patients who are not medically able to withstand surgery. This is a one-day procedure done while the patient is sedated but awake. The goal of radiosurgery is to halt progression of tumor growth. This occurs over time. Since the tumor is not removed, an absolute determination of the makeup of the tumor cannot be determined. 

Most patients have the procedure and are discharged home the same day or early the next morning. The gamma knife has been in use at Aurora St. Luke's Medical Center since 1999. Approximately 50 patients are treated each year.