Vestibular Schwannoma Surgery: A Complete Guide

vestibular schwannomaVestibular schwannoma surgery has a 78.2% to 86.9% success rate. It’s amazing how far the techniques for removing an acoustic neuroma have come. And, depending on the size and location of yours, you may be eligible to get surgery for your vestibular schwannoma.

A vestibular schwannoma, also known as an acoustic neuroma, can cause a myriad of symptoms in the patients that have it. By having vestibular schwannoma surgery, you could see a decrease in the growth of the acoustic neuroma as well as the symptoms that this tumor is causing.

If you’re interested in learning more about what acoustic neuroma surgery can do for you, keep reading.

What Is Gamma Knife Vestibular Schwannoma Surgery?

Compared to traditional surgery for acoustic neuromas, the Gamma Knife procedure is minimally invasive. In fact, Gamma Knife isn’t a surgical procedure at all.

Rather, it’s a form of radiation that has been successful at targeting acoustic neuromas. It uses multiple beams of radiation to focus on that tumor specifically. This way, you don’t expose the surrounding structures to radiation.

Gamma Knife is noninvasive, so you won’t have to deal with the same kind of recovery that traditional surgery requires. And, there are fewer side effects with this kind of radiation since it’s targeted to one area.

Overall, the procedure leads to fewer symptoms, less pain, and an easier recovery period.

If you’re interested in the Gamma Knife procedure, we can help you explore your options.

What Is Vestibular Schwannoma Surgery?

The goal of vestibular schwannoma surgery must always be to remove as much of the tumor as is safely possible. It is more invasive than techniques like the Gamma Knife procedure, but it may be necessary depending on the specifics of your tumor.

While the surgeon is doing this, they have to avoid damaging the important nerves that lie around the tumor. These nerves control facial movement, hearing, balance, and more. Luckily, improvements in surgical techniques over time have made acoustic neuroma surgery safer and more effective.

Acoustic neuroma surgery involves the collaboration of different surgical experts. Usually, neurosurgeons and ENT surgeons work together to perform surgeries to remove acoustic neuromas.

Approaches to Vestibular Schwannoma Surgery

There are several approaches to vestibular schwannoma surgery:

  1. Retrosigmoid approach
  2. Translabyrinthine approach
  3. Middle fossa approach
 

All of these techniques can be successful at removing acoustic neuromas, but each one is best for specific cases. So, your vestibular schwannoma surgery specialist is going to decide which approach to take based on your individual case.

The retrosigmoid approach is also known as the retromastoid approach or the suboccipital approach. This surgery involves making an incision behind the affected ear. Then, the surgeon will remove the bone that’s there to expose the tumor.  Surgeons can use the retrosigmoid approach on tumors of almost any size.

The translabyrinthine approach involves making a similar incision while removing the bone as well as the structures of the middle ear. This makes for easier access to the tumor.

By its nature, the translabyrinthine approach does cause complete deafness. In light of this, doctors are careful when selecting to use this approach. And, they normally opt to use it in individuals who have lost their hearing.

The middle fossa approach, or subtemporal approach, works well for patients with small tumors who haven’t lost their hearing. This surgical technique involves making an incision above the ear in order to access and remove the tumor.

No matter the kind of surgery that your specialist chooses, they will make sure to do their best to keep your nerves intact. In fact, surgeons use advanced technology to monitor their surgical techniques so that they can minimize the risk of unnecessary damage.

What Are the Vestibular Schwannoma Surgery Risks?

Surgery is always risky. No matter how many medical advancements we make, it’s likely that surgical risks will always be around.

With that, we need to go over the potential risks that surgical patients may have as a result of vestibular schwannoma surgery. Here is a list of the most common complications that this kind of procedure can present:

  • Cerebrospinal fluid leak
  • Meningitis
  • Facial nerve paralysis
  • Headache
  • Disordered vestibular compensation
  • Cerebellar injury
  • Brain stem injury
  • Vascular complications in the affected ear
 

As we highlighted earlier, patients who have acoustic neuroma surgery can suffer from permanent hearing loss. But, some patients do unfortunately lose their hearing due to the tumor before having any procedures.

What Does Vestibular Schwannoma Surgery Recovery Look Like and How Does It Compare to Gamma Knife Recovery?

After you have your vestibular schwannoma surgery, you’ll have a follow-up appointment with the neurosurgeon. This will usually be about 7 to 14 days after the surgery.

Your full recovery time will vary from four to six weeks, depending on how big your acoustic neuroma was and how long the surgical procedure lasted.

If you opt for the Gamma Knife procedure, you’ll be able to go home within an hour of completing the treatment. And, you’ll be able to return to normal activities just 24 to 48 hours after the treatment.

Upon leaving, the nurse will review your discharge instructions with you and ensure that you have a follow-up appointment scheduled. 

Where Can I Find a Vestibular Schwannoma Specialist?

If you or someone you love has a vestibular schwannoma, traditional surgery or Gamma Knife may be the way to go. You should contact our office to get a consultation for your vestibular schwannoma.

Based on your condition, we’ll be able to pinpoint the right course of treatment for you. Given our success with the Gamma Knife treatment, this less invasive course may be better for your tumor.

No matter what you choose, we’d be happy to help you find out the best choice of treatment whether it be the Gamma Knife or vestibular schwannoma surgery. 

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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