Acoustic Neuroma

Treatment for acoustic neuroma -- a type of skull base tumor -- takes a team of providers, including neurosurgeons, otolaryngologists, otologists and neurotologists (specialized ear, nose, and throat doctors who complete an additional two years of training to treat ear disorders), and radiation oncologists, among others. This team works closely with you to create an individualized treatment plan that addresses your unique situation and needs. Depending on your treatment preferences, symptoms, and the size and location of your acoustic neuroma, a watchful waiting approach may be an option for you. More comprehensive treatments to address the tumor itself include:

Lateral Skull Base Surgery
The best hospitals for acoustic neuroma surgery have surgeons like ours who are specifically trained and highly experienced in removing acoustic neuromas. We conduct a careful evaluation and examination to learn more about your condition and medical history before determining whether surgery on the lateral (side) of your skull is the best option. Whenever possible, we use minimally invasive techniques to reduce hearing loss, improve balance, and minimize facial weakness. When appropriate, we use surgical approaches that are most likely to preserve hearing. When large tumors or significant hearing loss is present, we may use an approach that is more direct. 

Radiation Therapy
Image-guided radiation therapy, including stereotactic radiosurgery, targets the tumor while preserving 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.

Medication
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

Beyond treating the tumor itself, we have a wide range of options to treat the possible symptoms of an acoustic neuroma, including hearing loss, balance problems, and facial weakness or facial paralysis.

Cochlear Implants
Our surgeons can work around 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 the few centers in the U.S. where surgeons have successfully performed this novel procedure, and is one of the only sites where surgeons remove the tumor and place the cochlear implant during the same surgery.

Vestibular Rehabilitation Therapy
This special form of physical therapy trains your body and brain to make up for inner-ear dysfunction, helps you feel steadier on your feet, and relieves or reduces disabling symptoms.

Facial Reanimation Surgery
This surgery may be recommended if you experience total or near-total loss of your ability to show facial expression.

Duke has one of the most comprehensive testing facilities in the region for evaluating acoustic neuromas. This allows us to recommend the best, most customized treatment options and improve your outcomes.

Functioning Tests
Experts assess your hearing (auditory brainstem response, or ABR), balance, strength, coordination, reflexes, vision, swallowing, and ability to think and remember. 

CT, MRI, and PET Scans
These imaging tests help detect and diagnose the type, location, and size of your skull base tumor. These tests usually last 30-60 minutes and are virtually painless.

Angiography
A radiologist inserts a small, flexible tube (called a catheter) into a blood vessel to deliver a contrast dye, making your blood vessels visible on X-ray. This test helps doctors know more about the bloody supply for your acoustic neuroma.

Biopsy
In some instances, our specialists may remove a small sample of the tumor in order to learn more about it.

High-Volume Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. You'll be among others from around the region and beyond who travel to Duke for acoustic neuroma care.

Patient Navigators Coordinate Your Care
Once you are diagnosed with an acoustic neuroma, our patient navigators become your one-stop shop for scheduling appointments, coordinating your visits, communicating your test results, and planning your surgery. It’s their job to make your skull base tumor treatment journey easier by guiding you through it step by step. And they are more than willing to answer all of your questions along the way.

Follow-Up Care Near Your Home
Once you've been treated at Duke, you may wish to continue your treatment closer to home. We will work with your local providers to coordinate care near your home, which may include radiation, other medication management, or follow-up care and therapies.