Expert: Dina Q Goldin, Ph.D. - 8/12/2008

Question
QUESTION: It has been determined that I have a 5 to 6 mm intracochlear schwannoma of the inner ear.  I have suffered progressive hearing loss and pulsatile tinnitus.  Is there any treatment that would help either perserve hearing or tone down the tinnitus??

ANSWER: Radiosurgery, especially hypofractionated FSR, has a better record of preserving hearing than any other AN treatment, especially than surgery. "FSR" means "fractionated streotactic radiosurgery", "hypofractionated" means 3-5 fractions rather than 25-30 as some centers have.  There are many stories from patients who had this treatment in the AN Archive (www.anarchive.org).

---------- FOLLOW-UP ----------

QUESTION: Thank you!  I live in NJ.  Is there any facility that you are aware of in my area (Delaware Vallely) that performs this technique (hypofractionated FSR) for a intracochlear schwannoma of the inner ear?  Thus far surgeons are not aware of any other treatment and indicate that surgery which is not indicated until total healing loss occurs or balance problems surface which would then remove the cochlear rendering deafness.  Also, can gamma knife be used for this particular problem if you know?

Answer
At this point, your AN is very small, and the best course of action is to monitor its growth with semiannual MRIs without taking any further action.  ANs tend to grow slowly if at all; many ANs never grow large enough to require treatment.  Though you do risk hearing loss by waiting, the same risks exist with any treatment you may have -- surgery, Gamma Knife, and FSR -- though they are less with FSR. One of the best FSR centers in the country is at the John Hopkins University in Baltimore; even if it is far from your house, it is worth traveling to.  The AN Patient Archive (www.anarchive.org) has stories from patients treated there, if you want to read what it is like.