Acoustic neuroma natural history, complications & prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Common complications of acoustic neuroma include hearing loss, facial numbness and weakness, difficulty with balance, ringing in the ear, hydrocephalus and recurrence of tumor. Due to improved surgical techniques and early diagnosis, the morbidity associated with surgical removal of these lesions is reduced. Acoustic neuroma patients have a very good prognosis with minimal complications if treated.[1] [2] [3]
Natural History
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. Common complications of [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
If left untreated about 50% of acoustic neuromas grow slowly (1-2 mm/year). The growth rate is constant for each patient, and can be predicted after 1 to 2 years of observation with serial MR scans. In approximately 20% of patients, the growth rate is more rapid (more than 2 mm/year). In more than 30% of patients acoustic neuromas seem not to grow. Acoustic neuromas does not metastasize to other parts of the body. The tumor may continue to grow and press on structures in the skull. Once hearing loss occurs, it does not return after surgery or radiosurgery. If treated acoustic neuroma patients have a very good prognosis with minimal complications if treated. People with small, slow-growing tumors may not need treatment
With the emergence of magnetic resonance imaging(MRI) with gadolinium, acoustic neuroma tumors as small as 2 mm in diameter can be accurately detected. Due to improved surgical techniques and early diagnosis, the morbidity associated with surgical removal of these lesions is reduced.[2] In select group of patients(patients older than 65 years with acoustic neuroma): however, no treatment may be the most appropriate management.[4]
Prognosis
- An acoustic neuroma is not cancer. The tumor does not spread (metastasize) to other parts of the body.
- The tumor may continue to grow and press on structures in the skull.
- Once hearing loss occurs, it does not return after surgery or radiosurgery.
- People with small, slow-growing tumors may not need treatment.[5]
- Acoustic neuroma patients have a very good prognosis with minimal complications if treated.
- 40%-60% of small tumors may not require treatment.
- A control rate of greater than 90% is found in tumors treated with focused radiation.
- A recurrence rate of less than 5% has been found following surgery.
- Patients experience very good (equal) quality of life whether treatment is observation, radiation, or surgery.
Complications
An acoustic neuroma may cause a variety of complications, including:[6]
- Hearing loss
- Facial numbness
- Difficulties with balance
- Ringing in the ear
- Hydrocephalus
- Recurrence of tumor
- Facial weakness
References
- ↑ "NIH acoustic neuroma Prognosis".
- ↑ 2.0 2.1 Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB (1994). "The natural history of untreated acoustic neuromas". Laryngoscope. 104 (9): 1115–9. doi:10.1288/00005537-199409000-00011. PMID 8072358.
- ↑ "NHS choices acoustic neuroma complications".
- ↑ Rosenberg SI (2000). "Natural history of acoustic neuromas". Laryngoscope. 110 (4): 497–508. doi:10.1097/00005537-200004000-00002. PMID 10763994.
- ↑ "NIH acoustic neuroma Prognosis".
- ↑ "NHS choices acoustic neuroma complications".