Acoustic Neuroma Surgery/Treatment


Introduction

An Acoustic neuroma (also known as Vestibular Schwannoma, Cerebellopontine Angle Tumour) is a tumour that slowly grows within the nerve connecting the ear to the brain. The nerve connecting the ear to the brain is known as VESTIBUL COCHLEAR NERVE. It is located behind the ear and below the brain. Acoustic neuroma is benign (non-cancerous) and hence other parts of the body do not get affected by this tumour, however, it can considerably affect nerves if not controlled within time.

What is Acoustic Neuroma?

Acoustic neuroma is generally related to genetic disorders and is not very common. It is a benign tumor, which grows gradually with the overproduction of the Schwann cells. It presses the hearing and the balancing nerves in the inner ear. There are two subtypes of acoustic neuroma Unilateral acoustic neuromas and Bilateral acoustic neuromas. It is a slow-growing tumor and it directly affects balance and hearing and causes hearing loss, unsteadiness, and ringing in the ear.

Cause of Acoustic Neuroma:

Acoustic neuroma is generally caused by a genetic disorder. However, it can also be caused by exposure to high radiations or continuous exposure to very loud noise. It is important to mention that cause for acoustic neuroma is usually not identified in most of the cases.

Symptoms of Acoustic Neuroma:

There are several symptoms associated with acoustic neuroma depending upon its size and location. Some of the common symptoms of acoustic neuroma are:

  • Hearing loss in the affected ear
  • · Tinnitus (ringing in the ear)
  • Vertigo when the person feels like everything is spinning

There are several other symptoms which are not very common in all cases of acoustic neuroma but the person suffering from acoustic neuroma might suffer the following:

  • Dizziness
  • Numbness in face or ear
  • Pain in face or ear
  • Constant headache
  • Weakness in face
  • Problem in balancing
  • Constant confusion

In case you experience one or more symptoms as mentioned above, you are advised to consult your doctor at the earliest as early diagnosis will help you in preventing the tumor from going and adversely affecting your body which may also result in total hearing loss.

Types of Acoustic Neuroma:

Acoustic neuroma can be classified into two categories which are as under:

  • Unilateral Acoustic neuroma: Unilateral acoustic neuroma is a situation when only one ear gets affected. This is the most common acoustic neuroma across the world. The most common age group for acoustic neuroma is between 30-60 years.
  • Bilateral Acoustic neuroma: bilateral acoustic neuroma is a situation when both ears are affected. It is also possible that a person has been suffering from bilateral acoustic neuroma since birth. One of the common causes of bilateral acoustic neuroma is a genetic disorder known as NF2 (neurofibromatosis2).

Acoustic Neuroma Surgery / treatment in India

The removal of brain tumor by keyhole (small) incisions are done through the small openings to minimize the damage of the surrounding scalp, brain, blood vessels, etc. It is also known as the retro-sigmoid craniotomy. It is performed to remove the skull-base tumors by making a small incision behind the ears, which allows access to the surgeon. It is a less painful technique to remove the brain tumor. Also, faster recovery and minimal scarring are the additional benefits of this procedure.

Diagnosis

Acoustic neuroma is a little difficult to diagnose as its symptoms are common to other minor problems related to ears. Initially ear examination and the hearing test may be performed. CT scan and MRI can be conducted to know the exact location and size. Some of the methods of diagnosing acoustic neuroma are:

  • · A hearing test (audiometry): A trial of hearing capacity, which quantifies how well the a patient hears sounds and discourse is generally the primary test performed to analyze acoustic neuroma. The patient tunes in to sounds and discourse while wearing headphones connected to a machine that records reactions and measures hearing capacity. The audiogram may show expanded "unadulterated tone normal" (PTA), expanded "discourse gathering edge" (SRT) and diminished "discourse separation" (SD).
  • · Brainstem auditory evoked responses(BAER): This test is performed in certain patients to give data on cerebrum wave movement as a reaction to snaps or tones. The patient tunes in to these sounds while wearing terminals on the scalp and ear cartilage and headphones. The anodes get and record the mind's reaction to these sounds.
  • Magnetic resonance imaging (MRI): If different tests show that the patient may have an acoustic neuroma, attractive reverberation imaging (MRI) is utilized to affirm the conclusion.

X-ray utilizes attractive fields and radio waves, as opposed to x-beams, and PCs to make point by point photos of the cerebrum. It shows visual "cuts" of the mind that can be joined to make a three-dimensional image of the tumor. A different color is infused into the patient. On the off chance that an acoustic neuroma is available, the tumor will absorb more color than ordinary cerebrum tissue and show up obviously on the output. The MRI usually shows a thickly "upgrading" (brilliant) tumor in the inner sound-related trench.

In case any person tests positive with acoustic neuroma, it is important that it should be treated without any unreasonable delay with utmost care. In case of any unreasonable delay, a tumor can affect the surrounding nerves and hearing capability of that person will be at stake. Acoustic neuroma can be treated in several ways which are as under:

  • Observation: this treatment requires a lot of patience and is advisable in case the tumor is in an early stage. Since acoustic neuroma is benign, immediate treatment can be avoided. A patient can be kept under observation with regular MRI scans and its treatment can be tried using drugs. In case acoustic neuroma grows or gets serious other treatments can be adopted.
  • Radiation therapy: some acoustic neuroma can also be treated using radiation therapy when a large number of radiation dose is sent to the affected area due to which the tumor stops increasing and even shrinks in some of the cases. There are two possible ways to perform radiation therapy:
    • Single fraction stereotactic radiosurgery (SRS) when many radiations are sent to the tumor in one session. In this method, only one session with higher doses is performed.
    • Multi-session fractionated stereotactic radiotherapy (FRS) when smaller doses are sent to the tumor in several sessions daily for a few weeks. Studies have suggested that FRS is more effective and reliable as compared to SRS. Radiation therapy does not require the patient to be admitted to the hospital. Radiation therapy stops the growth of the tumor or even in some cases it shrinks the tumor, however, the tumor is not completely removed using radiation therapy.
  • Surgery: it is the most effective Acoustic neuroma treatment in India as the entire tumor can be removed using the surgery. There are three ways in which surgery for acoustic neuroma can be done. Which are as under:
    • Trans labyrinthine includes making an entry, point behind the ear and evacuating the bone behind the ear and a portion of the center ear. This methodology is utilized for tumors bigger than 3 centimeters. The upside of this methodology is that it permits the specialist to see a significant cranial nerve (the facial nerve) obviously before expelling the tumor. The drawback of this system is that it brings about irreversible hearing misfortune.
    • Retro sigmoid/suboccipital which includes uncovering the rear of the tumor by opening the skull close to the rear of the head. This methodology can be utilized for expelling tumors of any size and offers the chance of saving hearing.
    • Centre fossa which includes evacuating a little bit of bone over the ear channel to access and expel little tumors kept to the inward sound-related trench, the thin path from the cerebrum to the center and internal ear. Utilizing this methodology may empower specialists to save a patient's hearing.

Pre and Post-procedure Care for Acoustic Neuroma Treatment

It is advisable to undertake all the precautions and majors as advised by your doctor. In the case of surgery for acoustic neuroma, your doctor is likely to prescribe you some antibiotic and steroids as per the requirement. You should inform your doctor about other medicines you are taking so that doctor can take a call if you have to discontinue taking the same.

Patients with a habit of smoking and drinking are advised to quit the same for some time.Once the surgery is done the patient is likely to suffer some discomfort or fatigue. This treatment does not require rigorous post-procedure care; however few precautions are required to be taken for speeding recovery which generally takes three to five weeks.

Patients are required to maintain high hygiene near the incision area. The patient should avoid working and driving as advised by the doctor. It is needless to mention that the patient should take medicines as instructed by the doctor.

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Complications in Acoustic Neuroma Treatment

In case any person has been diagnosed with acoustic neuroma, such a person must be treated using one of the ways mentioned above. However, it is important to understand a few complications that might arise. It is important to know that tumors can be completely removed through surgery, however, in the very rare case the person can suffer from paralysis of the face after being operated. Weakness in the face after the treatment might arise. In a few rare cases, a person may face delayed side effects of radiation therapy which include nerve damage leading to chances of paralysis in the face.

However, a lot depends on the age, health, and condition of the patient. A person must be treated with the best of the facilities by the team of experts so that any chances of side effects and complications can be minimized to the possible extent.

Why choose us for Acoustic Neuroma Surgey/Treatment in India?

Acoustic neuroma is an uncommon medical condition and its treatment is complex which requires the best of the facilities and highly skilled professionals. Our infrastructure and team of experts are considered to be one of the best in the country for providing proper treatment for acoustic neuroma in India. We understand that there are major complications and high risk involved and any mistake is likely to cost the patient’s hearing capability and hence we provide the best of the treatment with a team of experienced professionals having vast knowledge and experience in treating acoustic neuroma for many years.

We believe in providing the best care to the patients depending upon their specific needs. We are the best when it comes to Acoustic neuroma treatment in India as we believe in treating the person and not just the disorder. Every patient is unique, every problem is different and so is our treatment for them. Our services are unique and customized according to your problem. We provide you with the treatment best suitable to you and we formulate a program according to your requirements and continue to monitor your progress.

Acoustic Neuroma Surgery/Treatment Cost in India

Advancement and development in medical facilities have provided several options for providing the best care to the patient. There are many advances in India for the cost effective acoustic neuroma treatment which provides the best of the results. Acoustic neuroma treatment costs a fortune in various developed countries such as the USA, UK, Canada, Australia, etc. Many countries also face the challenge of the long and unpredictable waiting list for this surgery. Also, many underdeveloped and developing countries don’t not have reliable facilities for acoustic neuroma treatment.

All of the above make India the best location for acoustic neuroma surgery/treatment where you can get it done with the best of the surgeons and technology at very nominal charges and without a waitlist. We, at Paras Hospital, provide the best Acoustic Neuroma Surgery/Treatment in India with the latest technology and best of the surgeon at most nominal prices. Dr Sumit Sinha treats Acoustic Neuroma Surgery/Treatment in the most inaccessible areas.

Lecturing on Minimally invasive spinal surgery at recently concluded meeting by Artemis hospitals Gurugram.