Overview
What are the signs and symptoms of acoustic neuromas?
How are acoustic neuromas diagnosed?
How are acoustic neuromas treated?
What is the role of stereotactic therapy in the treatment of acoustic neuromas?
What is the role of surgery in the treatment of acoustic neuromas?
Which factors have led to improved treatment outcomes for acoustic neuromas?
What is the prevalence of acoustic neuromas?
What causes acoustic neuromas?
What is the pathophysiology of acoustic neuromas?
What are the most common symptoms of acoustic neuromas?
What are the less common symptoms of acoustic neuromas?
What are indications for treatment of acoustic neuromas?
What is the anatomy of the cerebellopontine angle relevant to acoustic neuromas?
What is the anatomy of nerves relevant to acoustic neuromas?
What is the anatomy of the internal auditory canal relevant to acoustic neuromas?
What is the anatomy of the temporal bone relevant to acoustic neuromas?
What are contraindications to the surgical removal of acoustic neuromas?
Workup
What is the role of lab tests in the workup of acoustic neuromas?
What is the role of imaging studies in the workup of acoustic neuromas?
What is the role of audiometric testing in the workup of acoustic neuromas?
Which histologic findings are characteristic of acoustic neuromas?
How are acoustic neuromas staged?
Treatment
What is the role of stereotactic radiotherapy in the treatment of acoustic neuromas?
What are the treatment options for acoustic neuromas?
What is the role of fractionated stereotactic therapy in the treatment of acoustic neuromas?
What is the role of surgery in the treatment of acoustic neuromas?
What are the surgical approaches used in the treatment of acoustic neuromas?
How does auditory brainstem response affect the selection of treatment for acoustic neuromas?
How do electronystagmography (ENG) findings affect the selection of treatment for acoustic neuromas?
How does tumor size affect the selection of treatment for acoustic neuromas?
How does tumor position affect the surgical approach for treatment of acoustic neuromas?
Which anatomic variations make the translabyrinthine approach for acoustic neuromas more difficult?
What is the role of surgeon preference in the selection of treatment approach for acoustic neuromas?
What is the role of patient preference in the selection of treatment for acoustic neuromas?
How is the translabyrinthine approach performed for the treatment of acoustic neuromas?
How is the retrosigmoid approach performed for the treatment of acoustic neuromas?
How is the middle cranial fossa approach performed for the treatment of acoustic neuromas?
What is included in postoperative care following surgery for acoustic neuromas?
What is the role of MRI in the long-term follow-up of acoustic neuromas?
What are the possible arterial complications of surgery for acoustic neuromas?
What are the possible cerebellar complications of surgery for acoustic neuromas?
How is postoperative facial paralysis managed in acoustic neuromas?
How are the cerebrospinal fluid complications treated in patients with acoustic neuromas?
How does surgery affect tinnitus in patients with acoustic neuromas?
How are recurrence or residual acoustic neuromas treated?
How does surgery affect facial function in patients with acoustic neuromas?
How does surgery for acoustic neuromas affect hearing outcomes?
What is the role of rehabilitation following treatment of acoustic neuromas?
Guidelines
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This table shows the distribution of presenting symptoms, ie, the symptom that brought the patient to a physician and that constituted the patient's chief ailment.
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A small acoustic neuroma within the internal auditory canal is easily observed on postgadolinium MRI.
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These large bilateral acoustic neuromas are easily observed on MRI. This patient has neurofibromatosis II. Both tumors were eventually removed, leading to anacusis. Facial nerve function remained entirely normal bilaterally.
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The nerves of the internal auditory canal as observed in a cadaveric dissection are shown. The posterior wall of the internal auditory canal has been removed. F indicates the facial nerve. S is the superior vestibular nerve. VIII indicates the statoacoustic nerve as it leaves the brain stem, and P indicates the posterior ampullary nerve. The hollow arrow points to the posterior lip of the boney porous acusticus, and the solid arrow indicates the position of the vestibule. C indicates the cochlear aqueduct.
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The bone that must be removed for a middle cranial fossa approach is indicated in yellow. The tumor is in orange.
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The bone that must be removed for a translabyrinthine approach is indicated in yellow. The tumor is in orange.
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The bone that must be removed for a posterior fossa approach is indicated in yellow. The tumor is in orange.