Acoustic neuroma

Many people may not know much about acoustic neuroma, nor do they know what causes it, let alone what medicine can cure it. But don’t worry, as long as we know more about the relevant treatment and prevention methods, we can better stay away from the troubles of this disease. Here are some treatment methods for this disease, I hope you can understand it.

The less common the disease is, the more we need to understand its cause and treatment method. This will improve our understanding of the disease and help more friends stay away from the impact of acoustic neuroma in life.

Acoustic neuroma originates from the acoustic nerve sheath and is a typical neuroma. Since the acoustic nerve itself is not involved, the name of acoustic neuroma is inappropriate and should be called acoustic neuroma. Most tumors occur in the vestibular segment of the auditory nerve, and a few occur in the cochlear portion of the nerve. As the tumor grows, it compresses the lateral surface of the pons and the anterior edge of the cerebellum, filling the cerebellopontine angle. Most tumors are unilateral, and a few are bilateral; if accompanied by neurofibromatosis, the opposite is true. This tumor is a benign lesion and will not become malignant or metastasize even if it recurs multiple times. If it can be removed, it can often achieve a permanent cure. However, since the tumor is adjacent to the important brain stem, surgical resection remains a great challenge for neurosurgeons or otolaryngologists.

The main treatment option for acoustic neuroma is surgery. There are three basic surgical approaches: suboccipital approach, middle cranial fossa approach and translabyrinthine approach. The translabyrinthine approach cannot preserve hearing due to damage to the inner ear. When approaching through the middle cranial fossa, the first thing that needs to be treated is the upper wall of the internal auditory canal, which can fully expose the cochlear nerve, facial nerve, vestibular nerve and blood vessels supplying the inner ear in the internal auditory canal, which is very beneficial for the protection of the cochlear nerve and labyrinthine artery. However, this approach has a narrow field of view, bony landmarks are difficult to identify, and the anatomical structure of the cerebellopontine angle is poorly exposed. Bleeding is difficult to control and the temporal lobe is significantly stretched, so this surgical approach has great limitations. Some researchers believe that this approach is only suitable for patients who are young, whose tumors are located in the internal auditory canal or whose tumors are outside the internal auditory canal and whose diameter does not exceed 1 cm, and whose patients have good hearing before surgery. The suboccipital approach is often used by neurosurgeons. The main reasons are that the anatomical exposure is good and the relationship between the tumor, brainstem and internal auditory canal is relatively clear. It is suitable for all acoustic nerve tumors of different sizes. In addition, high-speed electric drills provide more convenient tools to grind off the posterior wall of the internal auditory canal, and electrophysiological monitoring technology of cranial nerve function is expected to reduce the surgical mortality rate of acoustic neuromas in the dangerous triangle of the cerebellopontine angle in the early 21st century. At the same time, there will be higher-quality surface and auditory nerve preservation technology.

There are three main treatment options for patients with acoustic neuroma: microsurgical radical resection; stereotactic radiotherapy and follow-up observation. Young patients with confirmed tumors that are growing are absolute indications for treatment; elderly patients aged 70 years and above who have no obvious symptoms and whose serial imaging data show no tumor enlargement should be observed regularly and followed up with imaging. In most countries, the most commonly used surgical approach for patients who require surgical treatment based on the above principles is the suboccipital approach, followed by the translabyrinthine approach. Neurosurgeons tend to prefer the former, while neuro-otologists tend to prefer the latter.

As long as we pay more attention to our lifestyle and eating habits, regularly participate in some relevant physical exercises and improve our body immunity, this can play a certain auxiliary role in our treatment of acoustic neuroma. I hope everyone can develop good habits and let us have a healthy body. May you be safe and happy.