Ear, Nose and Throat

5 Important Questions to Ask an Acoustic Neuroma Specialist

Originally published March 10, 2016

Last updated December 15, 2023

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A woman undergoes an ear exam in a medical setting

Acoustic neuromas are the second most common tumor inside the head. Also known as vestibular schwannomas, acoustic neuromas originate from the sheath of the balance nerve.

A common symptom of an acoustic neuroma is single-sided hearing loss and/or ringing in your ear; however, other symptoms can be associated with this tumor include unsteadiness, dizziness, facial numbness or tingling. This complex tumor can often go undiagnosed for years as they typically grow at a slow rate of 1.0 mm annually. These tumors can have a significant impact on your quality of life and therefore understanding the diagnosis and treatment options is critical.

If you have been diagnosed with an acoustic neuroma, you probably have many questions about possible treatment options and where might be the best place to seek treatment. To get a better understanding of the best questions to ask an otolaryngologist and neurosurgeon, we reached out to John S. Oghalai, MD, chair of the USC Caruso Department of Otolaryngology – Head and Neck Surgery at Keck Medicine of USC.

Dr. Oghalai details why the following five questions are the most important to ask your doctor.

1. “Are you a comprehensive center that provides all three forms of tumor management (observation, radiation and surgery) and all three surgical approaches?”

Dealing with an acoustic neuroma is such a delicate situation for otherwise healthy individuals. The reason you want to work with a comprehensive acoustic neuroma center is because they are able to address all aspects of your experience from the very beginning to well beyond treatment. At our center, we take the time to understand each individual situation and provide the treatment option that is best suited for the individual whether it be watch and wait, radiation or microsurgery. If surgery is indicated, we are able to expertly perform all three surgical approaches: middle fossa, retrosigmoid and translabyrinthine.

With a comprehensive center, you don’t just get access to surgeons: you get access to physical therapists, neuro-intensivists, neuro-anesthesiologists, neurologists, ophthalmologists, ICU nurses, physical therapists and audiologists with a high level of experience in understanding and treating the unique needs of acoustic neuroma patients.

2. “Is there a team approach with a board-certified neurotologist and neurosurgeon?”

The greater the commitment the hospital makes to you and the skill set of the team, the greater the outcome. A team approach is so important because you, as the patient, will have access to everyone on the team as they work together in a unified manner to work towards your recovery. By having a board certified neurosurgeon and neurotologist on staff, you can trust that the procedures at the facility of your choosing will be done with your best interest in mind.

3. “How many surgeries have you done in your career?”

By asking your surgical team how many surgeries they have done in their career, you are able to gain insight into just how experienced they are in the field. When you go in for a surgery for something as serious and complex as an acoustic neuroma, you want to make sure that your surgeons have the experience and a track record of success that you can trust. Our surgical volume also translates to a high level of acoustic neuroma experience of our entire hospital and nursing staff that work these patients on a daily basis.

4. “Will I regain my lost hearing?”

Knowing what to expect is important. You may be going into surgery with the mindset that things will get better. However, surgery does not return lost function. It stops the damage and preserves the hearing at the same level at the time of diagnosis in select cases. In only a third of patients, the ringing gets better. Yet, preservation is better than complete loss of hearing. It is important to have a detailed conversation with your surgeon about expectations for hearing preservation and the best approach for your tumor size, location and shape.

5. “What is the recovery process like?”

Although there are similarities in recovery from acoustic neuroma surgery, each patient’s journey is unique. Many factors come into play like age, tumor size, presurgery level of hearing, presurgery activity level and so on. A patient who undergoes surgery for an acoustic neuroma tends to fatigue easier in the early postoperative period as they recover and compensate from the impact to the hearing and balance systems. Because of this, recovery requires some grit and determination.

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