Cerebellopontine Angle Syndrome - Treatment: Medical Therapy

Treatment: Medical Therapy

Acoustic neuromas are managed in one of the following 3 ways: (1) surgical excision of the tumor, (2) arresting tumor growth using stereotactic radiation therapy, or (3) careful serial observation.

Observation

Simple observation without any therapeutic intervention has been used in the following groups of patients:

• Elderly patients
• Patients with small tumors, especially if their hearing is good
• Patients with medical conditions that significantly increase the risk of operation
• Patients who refuse treatment
• Patients with a tumor on the side of an only hearing ear or only seeing eye
  • In a number of series reported to date, the individuals who are being observed ultimately require therapeutic intervention in between 15-40%.
  • During an observation period, most (70% or more) patients who are eligible for hearing conservation surgery initially lost their eligibility.

Telian has analyzed the important variables that should be evaluated when observation is considered, and these include the following:2

1. preoperative hearing in both ears,
2. the risk of immediate hearing loss as a consequence of surgery,
3. the risk of facial nerve paralysis,
4. the risk of other surgical complications and their seriousness,
5. the patient's life expectancy,
6. the size of the tumor,
7. tumor growth rate, and
8. patients with neurofibromatosis type 2 (NF2) or bilateral tumors.