Acoustic Neuromas

Acoustic neuromas, also known as vestibular schwannomas, are benign tumors located on the balance nerve from the inner ear to the brain. They grow slowly, often causing increasing problems with:

  • hearing loss
  • imbalance
  • ringing in the ear (tinnitus)
  • weakness or numbness in your facial nerves

Acoustic neuromas are most common among middle-age men and women, but particularly women.

Treatment for acoustic neuromas can involve:

  • monitoring (because of their slow growth)
  • surgery
  • radiation therapy

Expert Care for Acoustic Neuromas

Acoustic neuromas require expert care because of their sensitive location. Vanderbilt's Skull Base Center is a leading provider of acoustic neuroma surgery, consistently performing more procedures than all other Tennessee hospitals combined.

Patients in Tennessee and beyond choose us for acoustic neuroma care because of our:

  • experience
  • team approach
  • dedicated patient care coordinator
  • success rates - ours rank among the best in the country for key criteria such as facial nerve preservation
  • Acoustic Neuroma Center of Excellence

Treating Acoustic Neuromas: Questions and Answers

Here are answers to common questions about acoustic neuroma surgery.

What is your expertise in removing acoustic neuromas?
Our doctors are experienced specialists, performing an average of five acoustic neuroma surgeries per month and 58 per year. Our neurosurgeons are fellowship trained in skull base and neurosurgical oncology and have a combined 40 years of experience in skull base surgery for acoustic neuromas.

What surgical approaches do you recommend?
We are comfortable with all surgical approaches and tailor each surgery to the needs of the individual patient. We are highly experienced with the translabrynthine approach, posterior fossa approach, infratemporal middle fossa approach, far lateral approach and other approaches for skull base tumors.

What is your success rate in preserving the facial nerve and hearing?
Facial nerve preservation is a significant priority for our physicians even more so than completely removing a tumor. We perform facial nerve monitoring and continuous electrophysiological testing to improve outcomes. Our facial nerve preservation rate is one of the best in the country.

Hearing preservation following surgery will depend on the size and location of the tumor on the hearing nerve. In many cases, the tumors are quite large, ruling out hearing preservation. When hearing preservation is possible, we monitor the hearing nerve to achieve the best outcomes.

Do you anticipate total tumor removal with a single operation? If not, what are the follow-up procedures?
We prefer not to stage procedures. Our goal is complete excision (removal) of your tumor or a partial excision while preserving the facial nerve. For very large tumors and in certain other cases, we may stage procedures if it serves you best as a patient.

In our experience, any remaining tumor left to preserve facial nerve function typically does not grow. We monitor tumor growth over time. In rare cases, we may need to radiate the small residual tumor. These tumors are generally responsive to radiation therapy.

Will a team of specialists perform my surgery?
Yes, we perform all of our skull base surgeries as a multi-specialty team that includes fellowship-trained skull base neurosurgeons and neurotologists.

What is your rate of surgical complication with respect to stroke, infection, bleeding, cerebral spinal fluid (CSF) leak and headache?
Our outcomes are excellent. Through research and new techniques, we have reduced our CSF leak rate to less than 5%. Our stroke rate is less than 1%. We have also reduced post-operative headaches to less than 5%. Our infection and bleeding rates are less than 1% following surgery.

How often will I need MRIs?
When observing a tumor, we typically perform the first MRI at six to 12 months. We follow this appointment with regular MRIs at one- to two-year intervals, depending on the tumors growth rate.

Following surgery, we perform the first MRI during your hospital stay to provide a baseline. We typically perform the next scan at one year. If your tumor was removed completely, your next scans are usually at three and five years. If your tumor was partially removed, you may need more frequent scans.

Does your hospital have a neurological intensive care unit (ICU)?
Yes, we have a 34-bed neurosurgical ICU with a dedicated intensive care team monitoring patients 24/7. All nurses and staff are specially trained to care for neurosurgery patients.