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

If left untreated, an acoustic neuroma can block the flow of cerebrospinal fluid and cause hydrocephalus, which may lead to severe vision problems and difficulty breathing and swallowing. Acoustic neuroma patients have a very good prognosis with minimal complications if treated.[1]

Natural History

If left untreated, an acoustic neuroma can block the flow of cerebrospinal fluid and cause hydrocephalus, which may lead to severe vision problems and difficulty breathing and swallowing. About 50% of acoustic neuromas grow slowly (1-2 mm/year). The growth rate is more rapid (greater than 2 mm/year) in about twenty percentage of patients. In more than 30% of patients acoustic neuromas seem not to grow. Acoustic neuromas does not metastasize to other parts of the body. Acoustic neuroma does not metastasize to other parts of the body. AN 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. People with small, slow-growing tumors may not need treatment.

Complications

Complications of acoustic neuroma include:[1]

Prognosis

  • An acoustic neuroma is not cancer. The tumor 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.
  • People with small, slow-growing tumors may not need treatment.[2]
  • Acoustic neuroma patients have a very good prognosis with minimal complications if treated.
  • Forty to sixty percentage 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 similar quality of life whether treatment is observation, radiation, or surgery.
  • 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.[3] In select group of patients(patients older than 65 years with acoustic neuroma): however, no treatment may be the most appropriate management.[4]

References

  1. 1.0 1.1 Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015
  2. "NIH acoustic neuroma Prognosis". 
  3. Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB (1994). "The natural history of untreated acoustic neuromas.". Laryngoscope. 104 (9): 1115–9. PMID 8072358. doi:10.1288/00005537-199409000-00011. 
  4. Rosenberg SI (2000). "Natural history of acoustic neuromas.". Laryngoscope. 110 (4): 497–508. PMID 10763994. doi:10.1097/00005537-200004000-00002. 

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