Lateral Skull Base Surgery
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.
Our surgeons are now working 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 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.
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.