Expert: Harriet B Jacobster, Au.D. - 6/8/2009

Question
I have recently been diagnosed with a vestibular schwannoma aka acoustic neuroma. My ENT referred me to a neurotologist.I am 60 years old in good health. The neurotologist has recommended waiting six mnoths and doing another MRI to see how much it has grown. It is small, but I do have some symptoms, hearing loss, persistent ringin in ears that gets worse when I lay down and dizziness. All of the information that he gave me and that I have read says that there are far less complications if you have surgery when it is small. Do you think I should get another opinion or just wait the 6 months.
Thabk you
Diane

Answer
Hi Diane,
So many things enter into the decision about treatment for an acoustic neuroma/vestibular schwannoma. Size is just one of them. General health is another to consider.  Remember, surgery does carry risks no matter what the size of the tumor.  Generally, an AN is a benign, slow growing tumor.  I have seen tumors that have remained the same size for years.  The usual procedure, especially with smaller ones, is to wait and see.  If you can avoid surgery all together, that is always the best option.  In six months time, the tumor will still most likely be small enough for a successful surgery, as long as there are no other co-existing problems.   

However, I am always encouraging second opinions in any case that may involve surgery.  So, if you think you would feel more comfortable getting a second opinion, by all means you should get one.  However, if you do decide to wait the six months, just be alert to any changes in your symptoms; in which case do not wait and consult your neurotologist immediately.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology