Treatment of neurinoma

Symptoms caused by the size and growth of the tumor. The most typical symptom is one-sided hearing loss on the side of the tumor, which is often overlooked or mistakenly associated with other causes (for example, age-related changes in hearing). Small tumors usually do not extend beyond the bone channel and lead to unilateral reduction of hearing, tinnitus (ringing and noise in the ear), coordination disorders and dizziness. As the tumor grows, hearing loss can progress, weakness of the face and impaired coordination, balance are added. Large tumors cause pression on the brain stem, which aggravates the disorder of coordination, causes a sensitivity disorders. Involving the trigeminal nerve leads to numbness of the face and sometimes to the pains of the arrow as a type of neuralgia. With increasing compression of the trunk, the pathways of circulation of the cerebrospinal fluid overlap, leading to hydrocephalus. It lead to headache, loss of vision, nausea, vomiting and other symptoms.

In general, the causes of the tumor of the auditory nerve are still unknown. None of the environmental factors (such as the use of mobile phones or eating habits) has a proven impact on the development of these tumors. Neurinomas of the vestibulocochlear nerve can be both sporadic (occur without apparent causes), and develop with such a hereditary disease as type 2 neurofibromatosis (NF-2). Sporadic cases account for 95%, while 5% of the remaining neurinas are associated with NF-2.
Neurofibromatosis is a rare disease that can occur in two forms. Type 1 – causes neural tumors throughout the body, especially in the skin. Type 2 – more often affects the central nervous system, in particular causes the development of bilateral neurinomas auditory nerves, creating a risk of complete hearing loss. The bilateral nature of the process influences on treatment, because the priority is the preservation of hearing.
Neurinoma of the vestibulocochlear nerve affects about 10 people per 1 million. Women are more common than men and are usually diagnosed between the ages of 30 and 60 years.

The doctor in detail asks about your complaints and history (history of previous and family illnesses), then make a general and neurological examination.
The final diagnosis is possible only after an additional examination, which usually takes no more than 1-2 days. Diagnostic procedures may include:

• Magnetic resonance imaging (MRI) of the brain with contrast enhancement is the gold standard for diagnosing tumors of the brain, including the neurinoma of the auditory nerves. MRI is a non-invasive, painless and safe study that uses a magnetic field and radio waves to obtain a detailed image of the brain tissue. MRI is very useful for detecting brain lesions and their effect on surrounding brain structures.
• Computer tomography (CT) is a non-invasive technique in which an image of internal structures is acquired using X-rays and a computer. It is especially useful for studying the state of bone structures and their changes under the influence of the tumor (for example, widening of the internal auditory canal or destruction of the adjacent bone).
• Audiogram is an examination of the hearing function performed by an otoneurologist (specialist in diseases of the auditory nerves). During the study, the headphones are worn on the patient, through which a number of sounds are heard in a certain sequence for each ear separately. Also, the study can be supplemented with a test for the recognition of oral speech. This test allows you to detect hearing loss, its side (with changes not noticeable to the patient) and the level at which the auditory analyzer (middle or inner ear) is struck.

Also, the doctor may prescribe a number of more detailed studies that are necessary in your particular case.

The treatment that is most appropriate in a particular case depends on age, general health and comorbidities, hearing, and tumor size. The larger the tumor, the more difficult the treatment. Therefore, early diagnosis and treatment are very important. Due to the significant individual characteristics of patients and the fundamental complexity of neurin treatment, it is important to turn to large medical institutions with a wide range of treatment methods and extensive experience in this matter.

Treatment is directed by a neurosurgeon in close cooperation with an otoneurologist and radiologist.

Neuromas of small size with minor manifestations can be observed by conducting serial MRI studies with a certain frequency (from once every 3-6 months to once a year) under the supervision of a neurosurgeon. The signal for a change in treatment tactics may be an increase in the tumor or the progression of symptoms. The average growth rate of neurinoma is 0.66 – 1.5 mm per year. At supervision in 40% – 50% of cases further there is a need for operation or irradiation because of growth of a tumor or increase in symptoms. Surveillance may be the best option for elderly patients, if they have comorbidities and tumors in the hearing ear.