Duke ear nose and throat surgeons and neurosurgeons use a comprehensive, personalized approach to diagnose and treat acoustic neuromas, also known as vestibular schwanomma. Our goal is to improve your quality of life by focusing on hearing restoration, balance improvement and minimizing dizziness.
Comprehensive Acoustic Neuroma Care
We offer multiple treatment options and care for non-cancerous growths called acoustic neuroma (also called vestibular schwannoma) found on the nerves responsible for balance and hearing. Our specialists use a comprehensive approach to treat the tumor and improve your quality of life by preserving your hearing and balance, minimizing facial paralysis, and reducing your pain. These improvements are so important that we are now actively evaluating how we can maximize your quality of life after treatment.
In a recent advance, our surgeons are now working around the acoustic neuromas – sometimes leaving them, or a portion of them, and the cochlear nerve intact – and inserting a cochlear implant to preserve or restore hearing. Duke is one of a handful of centers in the U.S. where surgeons have successfully performed this novel procedure, and one of the only sites where surgeons remove the tumor and place the cochlear implant in one surgery.
Choose Duke for Your Acoustic Neuroma Treatment
- A nurse navigator coordinates your care. Once you are diagnosed with an acoustic neuroma, our nurse navigator becomes your one-stop-shop for scheduling appointments, coordinating your travel, communicating your test results and planning your surgery. She guides you through this very complicated process and answers all your questions along the journey.
- We use the latest OR technology. We are one of only a handful of medical centers that have an intra-operative MRI (iMRI) in our operating rooms. Obtaining an MRI during surgery ensures complete removal of the tumor and reduces the need for multiple procedures.
- Receive a convenient diagnosis, via email if needed. Many of our patients travel far and have been assessed before they come to our office. If you had diagnostic scan or test performed elsewhere and are looking for a second opinion, you are welcome to email a copy of the results, or send a CD copy directly to our office. Our experts will review your results and create a treatment plan that will be most effective for your case.
- Our doctors work with your doctors. Once treated at Duke, you may wish to continue your treatment closer to home. We will work with your local providers to coordinate your care near your home, which may include radiation or other medication management.
- You have a personalized care team. Treating skull base tumors takes a team of specialists across many areas of expertise, including neurosurgery, radiation oncology, and otolaryngology. This team works closely with you to create an individualized treatment plan that addresses your unique health situation and needs.
- More comprehensive tests improve outcomes. Acoustic neuromas are complex conditions that can affect hearing, balance and facial movement. We have the most comprehensive testing facility in the region for evaluating your acoustic neuroma. This allows us to recommend the best-customized treatment options and improve your outcomes after surgery.
- We offer the latest medical advances. Our doctors constantly develop new techniques, test new treatments, and learn and apply the latest research to improve patient care and outcomes.
- You have access to clinical trials. You may be able to participate in clinical trials that study new therapies and procedures that target acoustic neuroma.
We conduct a careful evaluation and examination that includes details about your condition and medical history before determining if surgery is your best option. Our surgeons are trained and experienced in lateral skull base surgery to remove acoustic neuromas. Whenever possible, we use minimally invasive techniques to reduce hearing loss, improve balance problems and minimize facial weakness. When appropriate, we use hearing preservation surgical approaches including middle fossa approach and suboccipital (retrosigmoid) approach. When large tumors or significant hearing loss is present, we often use the Translabyrinthine (translab) approach.
Select patients may benefit from a procedure during which part of the acoustic neuroma is removed to relieve brain pressure, and provide room for a cochlear implant to restore hearing loss.
Image-guided radiation therapy targets the neuroma while preserving your healthy brain tissue. We use several imaging tools, including MRI and CT scans, to pinpoint the location of the neuroma and target the radiation dose. This ensures radiation is delivered only to the neuroma and spares healthy tissue.
Medications are sometimes used in conjunction with radiation therapy or surgery. We assess the size and location of your acoustic neuroma and your symptoms to develop the best treatment plan.
We offer more comprehensive tests for acoustic neuroma than most medical centers in the region, in order to properly diagnose and develop a treatment plan customized for each patient. Most tests can be performed in the same day.
Our doctors assess hearing (auditory brainstem response, or ABR), balance, strength, coordination, reflexes, vision, swallowing, and ability to think and remember.
Various imaging tests may be performed to help detect and diagnose the type of skull base tumor. These tests include CT or CAT scans, MRI scans, PET scans, and angiography.
In some instances, our specialists may remove a small sample of the tumor in order to pinpoint the right diagnosis.