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Acoustic Tumors (Vestibular Schwannoma)  are benign growths of the balance (or vestibular nerve) that in the newest research can occur in approximately 1 in 500 people.

The acoustic tumors tend to occur in the bony channel between the inner ear and brain. The lesions are slow growing (1mm/ year on average) and as they enlarge may start to press on the brain and brainstem with the potential to affect vital bodily functions such as breathing or blood pressure.

A vestibular schwannoma usually presents with hearing loss and vague imbalance.  They are classically identified on MRI.

Most acoustic tumors are observed initially with regularly scanning until they become very symptomatic or large. Treatment is then offered and this depends on the patient factors and the acoustic tumor size. The management is either with stereotactic (robot assisted) radiation or microsurgical removal.

Most large acoustic tumors are now removed either:

  • Behind the ear (retrosigmoid/suboccipital) with an attempt at preserving hearing
  • Through the ear (translabyrinthine) sacrificing the hearing.

Both operations require a team based approach with the ear surgery gaining access to the whole acoustic tumour and the neurosurgeon removing the vestibular schwannoma. The patient is in ICU for 1 night and in hospital between 3-6 days post operatively.

Nirmal has been performing acoustic tumour surgery with North Shore and Macquarie University Neurosurgeons since 2006.  He has performed hundreds of acoustic tumor surgeries.

Intracanalicular Vestibular Schwannoma: A Systematic Review and Meta-analysis of Therapeutics OutcomesAssessing the Quality of Patient Information for Vestibular Schwannoma on the Open Source Video Sharing Platform YouTube

Large Acoustic
Neuroma Surgery

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