Acoustic Neuromas
These benign slow growing tumours of the vestibular nerve sheath. More accurately they are vestibular schwannomas. The incidence of these tumours has been reported as 1 in 100 000, but with the use of MRI scanning to screen for tumours, the incidence has increased to up to 3 in 100 000. They may occur in association with neurofibromatosis (NF2 variety) when bilateral acoustic tumours may be found. Because of the relatively benign symptoms with which they present they can be easily missed. A considerable proportion of medicolegal claims against ENT surgeons is for missed or delayed diagnosis of acoustic neuromas.
Treatment options include:
Observation
(particularly in the older patients) with repeat scanning to check for growth.
Surgery
Stereotactic radiotherapy
Surgery is the preferred choice of treatment. Possibilities of facial nerve preservation and even hearing preservation depends primarily on the size, therefore early diagnosis and treatment is recommended.
