Acoustic Neuroma (Vestibular Schwannoma)
How We Can Help You
An acoustic neuroma (also called a vestibular schwannoma) is a noncancerous tumor that grows near your brain on the vestibular nerve, which is responsible for hearing and balance. As the tumor grows, it can push on nearby tissues and disrupt your hearing, balance, or the muscles in your face.
Stanford is a global referral center for the diagnosis and treatment of acoustic neuromas.
Treatments for acoustic neuromas include surgery, stereotactic radiosurgery (SRS) with the brand name CyberKnife, other forms of radiation therapy, or a combination of these therapies.
What We Offer You For Acoustic Neuroma
- Globally-recognized expertise in the diagnosis and treatment of acoustic neuromas.
- Team-based treatment planning that brings together specialists from neurosurgery, head and neck surgery, neuroradiology, radiation oncology, neurotology, neuropathology, audiology, physical therapy, speech and language pathology, and more.
- Advanced treatment options in radiation therapy, minimally-invasive surgery, genetic assessment and counseling, hearing and speech support.
- Comprehensive support services like occupational or physical rehabilitation, nutritional and emotional support to help you with your specific symptoms and the challenges of this experience.
- An active clinical research program dedicated to broadening options for the diagnosis and treatment of acoustic neuromas.
Acoustic Neuroma Treatment
Treatment for vestibular schwannoma varies depending on a tumor’s size and growth rate, as well as the patient’s hearing and balance, age, and general medical condition. You doctors will work with you on options to control the tumor and an restore your quality of life.
Treatment Overview
Family Risk Management
Treatment depends on the size of the acoustic neuroma, how fast it’s growing, and your overall health. To preserve your hearing, balance, and facial nerve function, we take a conservative, minimally-invasive approach to treatment, typically using a combination of surgery and radiation therapy. We surgically remove as much of the acoustic neuroma as possible and treat the remaining tumor with radiation.
- Monitoring – Some patients are monitored with repeated MRIs and hearing tests. Some schwannomas have already stopped growing by the time they are discovered and do not require procedural intervention.
- Surgery – Surgery is often performed jointly with an otologist/neurotologist (ENT surgeon specializing in the ear and surrounding structures) and a neurosurgeon specializing in skull base surgery. Surgery involves the use of a high-powered microscope to enable the surgeon to dissect the tumor off of delicate structures such as the facial nerve. Multiple surgical approaches can be used to reach the tumor. The recommended approach depends on the size and location of the tumor, and your level of hearing.
- Stereotactic Radiation – A computer-guided delivery system is used to deliver highly focused beams of x-ray radiation to the tumor, while minimizing effects to the surrounding tissue. While radiation does not remove the tumor, it can be effective in stopping the growth of a tumor.
- Combination of the above – In some cases, tumors that grow after radiation may later require surgery. In other cases, tumor remnants after surgery can grow and be treated with radiation.
- In addition to addressing the tumor itself, treatment of vestibular schwannoma also involves managing the symptoms associated with the tumor and any effects of surgery or radiation. This may include rehabilitation of any hearing loss and vestibular or balance therapy.
Having the genetic syndrome called neurofibromatosis type 2 increases your risk for a type of acoustic neuroma that affects both ears, called bilateral acoustic neuroma.
People with neurofibromatosis type 2 have a genetic mutation that can cause cells to grow out of control and lead to cancer.
If you have neurofibromatosis type 2, our specialists will work with you to recommend the most appropriate options for your treatment, and to genetically screen your family members to assess their risks for acoustic neuromas.
Family risk management is a partnership between our Neurogenetic Oncology Program and Cancer Genetics Program.
Treatment depends on the size of the acoustic neuroma, how fast it’s growing, and your overall health. To preserve your hearing, balance, and facial nerve function, we take a conservative, minimally-invasive approach to treatment, typically using a combination of surgery and radiation therapy. We surgically remove as much of the acoustic neuroma as possible and treat the remaining tumor with radiation.
- Monitoring – Some patients are monitored with repeated MRIs and hearing tests. Some schwannomas have already stopped growing by the time they are discovered and do not require procedural intervention.
- Surgery – Surgery is often performed jointly with an otologist/neurotologist (ENT surgeon specializing in the ear and surrounding structures) and a neurosurgeon specializing in skull base surgery. Surgery involves the use of a high-powered microscope to enable the surgeon to dissect the tumor off of delicate structures such as the facial nerve. Multiple surgical approaches can be used to reach the tumor. The recommended approach depends on the size and location of the tumor, and your level of hearing.
- Stereotactic Radiation – A computer-guided delivery system is used to deliver highly focused beams of x-ray radiation to the tumor, while minimizing effects to the surrounding tissue. While radiation does not remove the tumor, it can be effective in stopping the growth of a tumor.
- Combination of the above – In some cases, tumors that grow after radiation may later require surgery. In other cases, tumor remnants after surgery can grow and be treated with radiation.
- In addition to addressing the tumor itself, treatment of vestibular schwannoma also involves managing the symptoms associated with the tumor and any effects of surgery or radiation. This may include rehabilitation of any hearing loss and vestibular or balance therapy.
close Treatment Overview
Having the genetic syndrome called neurofibromatosis type 2 increases your risk for a type of acoustic neuroma that affects both ears, called bilateral acoustic neuroma.
People with neurofibromatosis type 2 have a genetic mutation that can cause cells to grow out of control and lead to cancer.
If you have neurofibromatosis type 2, our specialists will work with you to recommend the most appropriate options for your treatment, and to genetically screen your family members to assess their risks for acoustic neuromas.
Family risk management is a partnership between our Neurogenetic Oncology Program and Cancer Genetics Program.
close Family Risk Management
Left: Cross section of the skull base showing a small vestibular schwannoma on the right side of the head. The tumor arises from the hearing and balance nerve. It fills the inner bony ear canal, called the internal auditory canal, where the nerve providing motion to the face also resides.
Right: Cross section of the skull base showing a large vestibular schwannoma on the right side of the head. The tumor has grown into the space between the inner ear canal and the brainstem. The tumor has grown large enough to push on the sensation nerve of the face (trigeminal nerve). It has also grown large enough to push on the brainstem and the cerebellum.
Clinical Trials for Acoustic Neuromas
Clinical trials evaluate new approaches, devices, or medications in the treatment of acoustic neuromas. Ask your doctor or clinical trials coordinator about available trials that may be additional options for your care.
To learn more about the clinical trials we offer, contact Maria Coburn at 650-736-9551.
Our Clinics
Stanford Neuroscience brings together top neurologists, neurosurgeons, and interventional neuroradiologists who work side-by-side to offer you truly comprehensive, coordinated care.
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3rd Floor
Palo Alto CA, 94304
Phone: 650-498-6000
To schedule an appointment, please call: 650-723-6469
Acoustic Neuroma (Vestibular Schwannoma)
An acoustic neuroma is a noncancerous brain tumor that grows on the vestibular nerve, which is responsible for hearing and balance. As the tumor grows, it can push on nearby tissues and disrupt your hearing, balance, or the function of the muscles in your face.
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cyberknife