The doctors at Memorial Sloan-Kettering may recommend observation, radiation therapy, or surgery as treatment for acoustic neuromas. Our team considers a variety of factors — such as the size and location of the tumor, its involvement with important structures nearby, the severity of a patient’s symptoms, and the age and health of the patient — when making treatment recommendations.
If observation is the selected treatment plan, we recommend monitoring with regular MRI scans. If the tumor grows or symptoms progress, the team will reevaluate the patient’s needs and determine if treatment — surgery or radiation therapy — is necessary.
Surgery is the preferred treatment for patients with larger acoustic neuromas and in some patients with small tumors and good hearing.
At Memorial Sloan-Kettering, our neurosurgeons and neurotologist (skull-base surgeons who specialize in inner ear and neurological problems) are highly experienced in using the latest skull-base surgical techniques to remove tumors safely. Depending on its location and size, the surgeon may access the tumor from behind and slightly below the ear (called the retrosigmoid, or suboccipital, approach), through the inner ear (called the translabyrinthine approach), or above the ear (called the middle fossa, or subtemporal, approach). Sophisticated electrophysiologic nerve monitoring techniques are used throughout surgical procedures to avoid harming facial, hearing, and nerve function.
Radiation Therapy (Stereotactic Radiosurgery)
Many patients with acoustic neuromas may be candidates for stereotactic radiation therapy, or radiosurgery. Radiosurgery is a highly precise, minimally invasive method of delivering radiation directly to the tumor with little or no impact on surrounding structures. Using imaging data, our radiation oncologist works closely with a medical physics team to optimize tumor control while minimizing the risk of side effects.
Depending on the treatment plan, radiosurgery may be administered on a single day or on several consecutive days.
Our radiosurgical team uses the latest techniques, including:
- Frame-based Radiosurgery
A stereotactic frame is placed on the patient’s head to precisely deliver radiation to the acoustic neuroma. This procedure is usually given as a one-time treatment on an outpatient basis.
- Image-guided Radiation Therapy (IGRT)
For IGRT, three-dimensional CT scanning is used to guide delivery of high-dose radiation directly to the tumor site. This enables our radiation oncologist to spare healthy tissue and avoid possible side effects.
- Intensity-modulated Radiation Therapy (IMRT)
IMRT is a type of external-beam radiation therapy that uses highly sophisticated computer software and three-dimensional images from CT scans to deliver radiation to tumors with greater precision than conventional methods. Using IMRT, the radiation oncologist can “mold” the dose of radiation to the tumor, delivering higher, more effective doses, while sparing healthy tissue and reducing the risk of side effects.