Acoustic Neuroma
Acoustic Neuroma (Vestibular Schwannoma): Understanding Treatment Options with a Skull Base Surgery Team
An acoustic neuroma—also called a vestibular schwannoma—is a non-cancerous tumor that grows on the balance and hearing nerve between the inner ear and the brain. Although benign, it can affect critical functions such as hearing, balance, and facial movement if left untreated.
Common Symptoms
Acoustic neuromas typically develop slowly and may cause:
Hearing loss in one ear (most common symptom)
Ringing in the ear (tinnitus, usually one-sided)
Imbalance or unsteadiness
Fullness or pressure feeling in the affected ear
Facial numbness or weakness (seen with larger tumors)
Because symptoms often appear gradually, diagnosis can be delayed. Fortunately, modern imaging such as MRI has made early detection more common.
Management Options
When it comes to managing acoustic neuromas, there are 3 main approaches:
1. Observation (“Wait and Watch” or “Watchful Waiting”)
For very small tumors—especially in older patients or those with other health conditions—monitoring with periodic MRIs may be appropriate. However, even small tumors can grow unpredictably. Some may eventually cause serious symptoms, including facial nerve involvement or brainstem compression. Tumors are measured on a millimeter scale to assess for growth between scans.
2. Radiation (Stereotactic Radiosurgery)
Radiation therapy—such as stereotactic radiosurgery (Gamma Knife or CyberKnife)—can be effective in halting tumor growth. It’s typically delivered in a single outpatient session and may stabilize small to medium-sized tumors. However, it does not remove the tumor, and long-term outcomes can include delayed regrowth or nerve injury. In cases where radiation is appropriate, I collaborate closely with radiation oncology specialists to ensure tailored, high-quality care.
3. Surgery (Microsurgical Removal)
Surgical removal remains the only definitive way to eliminate an acoustic neuroma. Modern microsurgical techniques—especially in experienced hands—offer excellent tumor control while maximizing facial nerve preservation. In smaller tumors, hearing preservation may also be possible. Surgery is often recommended for:
Growing tumors
Tumors larger than 20 millimeters (2.0 cm)
Healthy patients seeking a long-term solution without continued surveillance
disabling symptoms
Why Experience Matters
Surgery for acoustic neuroma requires precise technique and an expert understanding of skull base anatomy. I routinely perform these procedures alongside experienced neurosurgeons at East Jefferson General Hospital (EJGH) and West Jefferson Medical Center (WJMC). The two-surgeon team approach provides the highest level of safety—especially when it comes to preserving the facial nerve or decompressing the brainstem.
Our multidisciplinary skull base teams are experienced in evaluating each patient’s case in depth, offering truly personalized recommendations—whether that's surgery, observation, or radiation. No two acoustic neuromas are exactly alike, and our goal is to help you make the most informed choice for your health and lifestyle.
Advanced Training in Skull Base Surgery
After completing residency in general ear, nose, and throat (ENT) surgery, I was selected for two additional years of subspecialty training in neurotology and skull base surgery at the Michigan Ear Institute—a global leader in acoustic neuroma care. There, I gained extensive hands-on experience in all three treatment options, with particular emphasis on the surgical management of these complex tumors.
Moving Forward
If you've recently been diagnosed with an acoustic neuroma—or have been monitoring one for a while—it’s worth exploring all your options, including the potential benefits of early surgical intervention.
Have questions or want a second opinion?
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