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 VESTIBULE COCHLEAR NERVE. It is located behind the ear and below the brain. Acoustic neuroma is benign (non-cancerous). 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, instability, and ringing in the ear.

Cause of Acoustic Neuroma:

A genetic disorder generally causes acoustic neuroma. However, it can also be caused by exposure to high radiation or continuous exposure to thunderous noise. It is essential to mention that cause for acoustic neuroma is usually not identified in most cases.

Symptoms of Acoustic Neuroma:

Several symptoms are 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 is when the person feels like everything is spinning

Several other symptoms 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

If 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 prevent the tumor from going and adversely affect your body, resulting 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 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 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 Gurgaon

Brain tumour removal by keyhole (small) incisions is done through the small openings to minimize the damage of the surrounding scalp, brain, blood vessels, etc. It is also known as a retro-sigmoid craniotomy. It removes 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 the ears. Initially, ear examination and a 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:

  • ยท A hearing test (audiometry): A trial of hearing capacity, which quantifies how well the 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 reaction to snaps or tones. The patient tunes 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 instead of x-beams and PCs to make the point by point photos of the cerebrum. It shows visual "cuts" of the mind that can be joined to create a three-dimensional tumour image. A different colour is infused into the patient. On the off chance that an acoustic neuroma is available, the tumor will absorb more colour than normal cerebrum tissue and show up obviously on the output. The MRI usually shows a thickly "upgrading" (brilliant) tumor in the inner sound-related trench.

If any person tests positive with acoustic neuroma, it is important that it be treated without any unreasonable delay with utmost care. In case of any little 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 if 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 other severe treatments can be adopted.
  • Radiation therapy: some acoustic neuroma can also be treated using radiation therapy when many radiation doses are sent to the affected area. 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 than 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 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, pointing behind the ear, evacuating the bone behind the ear and a portion of the centre ear. This methodology is utilized for tumors more significant than 3 centimetres. 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 includes uncovering the tumour's rear by opening the skull close to the rear of the head. This methodology can be utilized to expel tumors of any size and offer the chance to save hearing.
    • Centre fossa includes evacuating some bone over the ear channel to access and remove tiny tumors kept to the inward sound-related trench, the narrow path from the cerebrum to the centre 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 antibiotics, antibiotics and steroids as per the requirement. You should inform your doctor about other medicines you are taking to 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 will likely suffer some discomfort or fatigue. This treatment does not require rigorous post-procedure care; however, few precautions are required to speed 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

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

However, a lot depends on the patient's age, health, and condition. A person must be treated with the best of the facilities by a 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 Surgery/Treatment in Gurgaon?

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 one of the best for providing proper treatment for an acoustic neuroma in Gurgaon. We understand that there are significant complications and high risks involved. Any mistake is likely to cost the patient's hearing capability. Hence, we provide the best 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 in Acoustic neuroma treatment in Gurgaon, 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 situation. 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 Gurgaon

Advancement and development in medical facilities have provided several options for providing the best care to the patient. India has many advances for cost-effective acoustic neuroma treatment, which provides the best 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 have reliable facilities for acoustic neuroma treatment.

The above makes India the best location for acoustic neuroma surgery/treatment. You can get it done with the best surgeons and technology at very nominal charges and without a waitlist. We, at Paras Hospital, provide the best Acoustic Neuroma Surgery/Treatment in Gurgaon, 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.