No one knows why these slow-growing tumors occur, or why more women than men develop them. Statistics vary, but acoustic neuromas are believed to develop in one of every 3,500 persons, and are most often diagnosed between the ages of thirty and sixty. The symptoms, unfortunately, are the same as with many other ear-related problems: reduction in hearing in one ear, noise or ringing in the ear, or unsteadiness and balance problems. These benign tumors along the eighth (hearing and vestibular) and seventh (facial) nerve require careful evaluation and the hands of a skilled specialist when they must be removed.

Monitoring the hearing and facial nerves during surgery helps in the outcome of the surgery. When an auditory brainstem response test (ABR, or BAER test) reveals an abnormality, an "imaging" procedure is required. While computed tomography (CT) scans can be used to detect most large acoustic neuromas, the most effective diagnostic image is produced by a magnetic resonance imaging (MRI) machine with intravenous gadolinium.

There is no magic drug to treat these slow-growing tumors. The treatment for acoustic neuroma in the elderly at this time involves "watchful waiting" and surgical removal at the appropriate time. While the surgical procedure is still considered delicate, the advances brought on by microsurgical instruments and monitoring the facial and hearing nerve have greatly improved the procedure. In elderly people, the facial nerve can be preserved in almost all cases by leaving a small portion of the tumor on the nerve. Facial movement has been normal in 95% of the cases.

Elderly people with small tumors are followed annually with an MRI exam. If the tumor gets large enough to compress the brain, removal of the tumor is indicated. Radiation treatment with a gamma knife is also an option.
Dr. Silverstein has been a pioneer in conservative surgery for acoustic neuroma, having developed a facial nerve monitor in 1985 that significantly reduces risk of facial weakness following this surgery. Very few patients have required a second surgery (14%). In the past ten years, no patient over age 65 presenting with a tumor less than ½ inch has needed surgery. The use of single dose stereotactic radiation may be used instead of surgery.

Anyone with unexplained hearing loss, loss of balance and ringing in the ears should see a specialist for diagnosis. These symptoms do not automatically mean there is a tumor, however. Florida Ear & Sinus Center is the recognized source for accurate and appropriate diagnosis and treatment. Knowing the diagnosis is the key to planning treatment and relieving the patient’s anxiety.

If you have any questions, need additional information, or would like to schedule an appointment, call TOLL FREE 1-888-418-9200