Treatment planning for an acoustic neuroma

Acoustic neuromas are benign tumors that involve the nerves responsible for facial movement, hearing, and balance. They are also sometimes known by the more anatomically accurate name vestibular schwannoma. They occur near the base of the skull adjacent to the brainstem and extend out into the bony canal through which the associated cranial nerves exit the skull.

Hearing loss in the ear on the side of the tumor is often the first symptom that patient's notice. If left untreated they can also cause symptoms of facial weakness, balance problems, and occasionally facial pain or numbness. Very large tumors can put pressure on the brainstem and cause a wide variety of conditions and symptoms.

This can occasionally cause an obstruction of the normal spinal fluid pathways causing a buildup of spinal fluid called hydrocephalus. This condition can be rapidly progressive and may represent a neurosurgical emergency. Most acoustic neuromas however are relatively small, usually less than three centimeters in diameter at diagnosis.