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10.09.2014

Tinnitus after acoustic neuroma surgery, yoga to cure sleeplessness - PDF Review

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An acoustic neuroma is a benign tumour arising from the Schwann cells or covering of the nerve to hearing and balance and represent about 6 - 10% of all brain tumours.
The acoustic neuroma arises from the balance portion of the 8th cranial nerve which is located deep inside the skull. The growth of acoustic neuroma is generally slow and tends to stretch surrounding nerves and structures including the facial nerve.
The cause of acoustic neuroma is unknown, but the genes controlling the growth of the nerve lining are the major area of research interest presently.
The treatment of acoustic neuroma requires careful consideration by experts in the management of these types of tumours. At The Ear Science Institute Australia (ESIA), the surgeons work in a team comprising ear and skull base surgeons (neuro-otologists), neurosurgeons, audiologists, anaesthetists, specialised nurses and balance physiotherapists. The specialised acoustic neuroma unit involving ESIA surgeons has an international reputation attracting patients from South East Asia, South Africa and throughout Australia.
A specialised acoustic neuroma surgery unit must be able to utilise three major surgical approaches when removing these tumours. The natural behaviour and treatment strategies are discussed, including surgery, carefully and clearly with the patient and their family. Patients are usually transferred to the ward on the first day after surgery and helped out of bed on the second post-operative morning.
The risks and complications described here are the most important and particularly relate to acoustic neuroma surgery, but are not an exhaustive account of risks during surgery. Some patients with good levels of hearing before surgery have small tumours confined to internal auditory canal.
Tinnitus (ear noise) is frequently present before surgery, which may remain the same following surgery but rarely represents a significant problem. Because the balance nerve may have been damaged by the tumour, surgery may result in improvement in unsteadiness. Stroke, brain injury and death are all rare following surgery in dedicated units (0.5 - 2%). There are three major approaches to acoustic tumour surgery: translabyrinthine, middle fossa and retrosigmoid.
A large number of patients with acoustic neuroma have poor hearing at the time of diagnosis.


The patients are usually discharged from hospital between the fourth and seventh day following surgery.
Acoustic neuromas are benign tumours but radiotherapy has been increasingly proposed and considered as a treatment. Hearing is preserved in many cases initially but progressively worsens over time compared to hearing preservation surgery. Evaluating the role of Magnetic Resonance Imaging Scans in the Surgical Management of Acoustic Neuromas.
This year in Australia over 100 people will be told they have a small mass growing in their inner ear, possibly extending into their brain, which may be a benign tumour called an acoustic neuroma. Less frequently, the rate of growth is more rapid but the prediction of the growth pattern of acoustic neuroma is extremely difficult.
The other 5% are bilateral (both sides) and are due to a hereditary condition called Neurofibromatosis type II.
A patient with a acoustic neuroma should question their clinician about their experience, results and willingness to publish or present these results to their peers. Surgery is carried out at St John of God Hospital Subiaco and Sir Charles Gairdner Hospital on private and public hospital patients.
In addition, surgeons visit from around the world to adopt new acoustic neuroma surgery techniques performed by our team. Balance rehabilitation is supervised by the balance physiotherapist and the patient is usually walking independently by the third or fourth day following surgery.
In general, the smaller the tumour at the time of surgery, the less chance of complications. This nerve controls the facial muscles and any disruption to it during surgery leads to loss of muscular tone and movement of the face on the side of the tumour (facial palsy). Brain fluid leaks occur in around 10% of cases, usually requiring a temporary spinal drain and less commonly, further surgery. Recent results indicate that radiotherapy is very effective in stopping tumour growth but long term results, after 10 years, are lacking. Therefore, the long term effectiveness of radiotherapy for acoustic neuroma is still unknown and will not be a fully established treatment until these results are known in future years. A decision on the best treatment should be made by the patient and their physician(s) after careful review of their situation.


The presence of a one-sided nerve hearing loss detected at routine hearing testing usually leads to the suspicion of acoustic neuroma but, in fact, most one-sided hearing losses are not due to acoustic neuroma. Before surgery, blood tests, xrays, hearing tests and other special investigations may be undertaken. All patients are transferred to the Intensive Care Unit (ICU) immediately following surgery. Some, especially older, patients do not achieve complete balance compensation following surgery and have imbalance. Special surgical techniques and electro monitoring systems are utilised by the ESIA team of surgeons to preserve the facial nerve. Radiotherapy does not result in disappearance of the tumour but aims to stop growth of acoustic neuromas. The Queensland Acoustic Neuroma Association Inc, authors and editors expressly disclaim any and all liability to all readers of this web site who act or fail to act as the result of reliance upon the whole or part of this web site. All NF II patients require expert care by a team of surgeons, neurologists, radiologists, geneticists, rehabilitation audiologists and speech pathologists. The three major treatment strategies are observation, surgery and radiotherapy which are discussed later.
Surgeons in the ESIA team are leaders in this area and have published papers showing most, but not all, of their patients have normal or near normal function following removal of acoustic neuroma in small and medium sized tumours. As with surgery, hearing loss, facial paralysis and other serious complications have all occurred following radiotherapy for acoustic neuroma.
In a small number of patients, the acoustic neuroma continues to grow after radiotherapy but surgical treatment is made much more difficult following radiation treatment. If the tumour is small and the patient still has useful hearing, then surgery to preserve this hearing may be recommended.
The aims of surgery for acoustic neuroma are to remove the tumour with preservation of all neurological of brain function. As acoustic neuromas are in close proximity to vital brain and nerve structures, this presents a complicated problem.



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Comments to “Tinnitus after acoustic neuroma surgery”

  1. SeNINLe_SeNSIz:
    Information on the causes and barley hear now, and.
  2. kvazemorda:
    Hearing loss, a hearing aid with previous studies, 50 per cent.