Philadelphia, PA: Elsevier; chap Hargreaves M. Osteomas and exostoses of the external auditory canal. Operative Otolaryngology Head and Neck Surgery. Benign tumors of the sinonasal tract. URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. Learn more about A. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
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July 31, Louis ED, et al. Acoustic neuroma and other skull base tumors. In: Merritt's Neurology. Wolters Kluwer; Proton therapy. American Brain Tumor Association. Carabenciov ID expert opinion. Mayo Clinic. March 31, Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.
Ceruminoma cancer of the cells that produce earwax develops in the outer third of the ear canal. These tumors do not spread metastasize to other areas but they are destructive to the ear canal. Ceruminomas have nothing to do with earwax buildup. Treatment consists of removing the tumor and surrounding tissue surgically. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
The Merck Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Commonly searched drugs. Noncancerous ear tumors. Cancerous ear tumors. Outer Ear Disorders. Acoustic Neuroma Vestibular Schwannoma Diagnosis Because symptoms of these tumors resemble those of other middle and inner ear conditions, they may be difficult to diagnose.
Acoustic neuroma diagnosis includes: Hearing test audiometry. This is a test of hearing function that measures how well you hear sounds and speech. It is usually the first test performed to diagnose acoustic neuroma. A doctor asks you to listen to sounds and speech while you are wearing earphones attached to a machine that records responses and measures hearing function.
If you have an acoustic neuroma, your audiogram may show the following. Increased pure tone average PTA. This metric evaluates how loud a sound frequency needs to be before you hear it.
Increased speech reception threshold SRT. This metric evaluates how loud speech needs to be before you hear it. Similar to pure tone average, the higher the score, the worse the hearing. Decreased speech discrimination SD. This metric evaluates how many words you can detect, one ear at a time. The lower the score, the worse the hearing.
Imaging scans of the head. If other tests point to a possibility of acoustic neuroma, MRI can confirm the diagnosis. MRI with a contrast dye can help pinpoint the tumor.
If an acoustic neuroma is present, it will soak up more dye than normal brain tissue and appear clearly on the scan. MRI commonly shows a densely "enhancing" bright tumor in the internal auditory canal. Are acoustic neuromas hereditary? Acoustic Neuroma Treatment After a diagnosis of an acoustic neuroma, the doctor will determine the best plan of action. The options include the following: Surgery to remove the tumor. This is a highly effective treatment for acoustic neuromas. Hearing loss that has already occurred from the tumor cannot be reversed, but the remaining hearing can be preserved in some cases.
Surgical tumor removal can often address balance problems, facial numbness and other symptoms. Stereotactic radiosurgery. This form of radiation therapy delivers precisely targeted radiation to the tumor while avoiding the surrounding healthy tissue. Radiation does not cause the tumor to go away. Rather, the goal is to stop or slow the growth. Typically, radiation therapy is not recommended for young patients and those with larger tumors.
This means waiting and watching, and it can be an option for some patients with acoustic neuroma. Because acoustic neuromas are usually slow growing, immediate intervention is not always necessary. Acoustic Neuroma Observation Acoustic neuromas are noncancerous tumors, so they can often be closely monitored without treatment. Acoustic Neuroma Surgery Modern microsurgical advancements have made acoustic neuroma surgery procedures safer, more effective and easier to recover from.
Suboccipital or retrosigmoid craniotomy. During this procedure, the surgeon accesses the acoustic neuroma from the back of the head. It offers the best view of the brainstem, particularly for the nerves involved in swallowing, which can be affected if a tumor is large.
This approach is often recommended for patients with larger tumors. It also might preserve hearing for patients with smaller tumors, because the inner ear structures are preserved.
Translabyrinthine craniotomy. During this procedure, the surgeon removes the bone behind the ear to access the tumor through the inner ear. This provides the best view of the entire length of the facial nerve and can require less retraction of the brain. However, it requires going through the structures of the inner ear and does not allow preservation of hearing.
This approach is generally considered for patients who have no functional hearing. Middle fossa craniotomy. This is an option for patients with smaller acoustic neuromas and intact hearing.
It is generally considered to provide the greatest chance of hearing preservation, but there is a slightly greater risk of facial nerve weakness after the surgery, and it cannot be performed for medium or large size tumors.
Image Guidance and Monitoring During Acoustic Neuroma Surgery Monitoring of brain and nerve function is a critical part of acoustic neuroma surgery. Stereotactic Radiosurgery for Acoustic Neuroma Radiosurgery , also called stereotactic radiosurgery, is a noninvasive procedure that uses precisely focused, narrow beams of radiation to treat the acoustic neuroma while limiting the amount of radiation that affects surrounding structures, including the hearing, balance and facial nerves.
What if an acoustic neuroma returns after radiosurgery? The Johns Hopkins Acoustic Neuroma Center As part of one of the world's largest brain tumor centers, The Johns Hopkins Acoustic Neuroma Center offers unmatched expertise in the evaluation, patient education and treatment of acoustic neuromas. Learn more about the Acoustic Neuroma Center.
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