Treatment of Acoustic Neuroma in Germany

Diagnostics

Most patients see a doctor because of hearing loss or symptoms associated with an increased intracranial pressure. Hearing is lost on one side, due to the impaired integrity of the cochlear nerve or a violation of its blood supply.

Other clinical manifestations are as follows: 

• ringing in the ears;
• deteriorated understanding of words; 
• dizziness; 
• headaches; 
• facial numbness. 

With an increase in size, the acoustic neuroma causes other symptoms associated with lesions of the nearby cranial nerves and areas of the brain. A patient may suffer from instability during head movements, nystagmus, lacrimation, facial muscle weakness, pain in the trigeminal nerve innervation zone, hoarseness, swallowing disorders, unsteadiness when walking, or speech disorders. With an increase in intracranial pressure, due to the impaired cerebrospinal fluid outflow, patients have elevated blood pressure, deteriorated mental abilities, and their consciousness may be disturbed.

The main method of instrumental diagnostics of the disease is an MRI scan. With the help of this test, the doctor can see the acoustic neuroma, assess its location, and choose the best treatment option.

Treatment options

One of the following three tactics can be used for treatment of an acoustic neuroma:

Watchful waiting. This strategy is chosen in children and elderly patients with severe comorbidities that make acoustic neuroma treatment unsafe. However, if the tumor grows or causes any symptoms and complications, then the specialists proceed to an active treatment.

Stereotactic radiosurgery. This treatment option allows for the destruction of the neoplasm with the help of irradiation. The specialized German centers use the CyberKnife system. It differs from other systems, such as the Gamma Knife, in its frameless fixation with a customized thermoplastic mask or vacuum mattress. As a result, a person does not need any stereotaxic frame, which is screwed to the skull. Radiosurgery is safer than surgery. In addition, this treatment method is non-invasive, painless, fast, and does not require any rehabilitation. It can be used in most patients, but severe brainstem or hypertensive-hydrocephalic (associated with increased intracranial pressure) symptoms are considered limitations.

Microsurgical resection. This therapeutic option is the most effective treatment for an acoustic neurinoma of any size, and quickly eliminates any clinical symptoms. In Germany, such operations are performed by experienced neurosurgeons, so you can count on a successful surgical intervention without any complications, and the preservation of your hearing.

Operations for an acoustic neuroma

An acoustic neuroma often has to be removed with surgical techniques. Doctors use different approaches to access the tumor and remove it.

Retrosigmoid approach. This approach is the main one in skull base surgery. It provides good access to the cranial nerves located in this area. With this approach, doctors can remove a tumor of any size and have the possibility of preserving a patient’s hearing.

Middle cranial fossa approach. This approach is also a hearing-sparing technique and is most suitable for tumors with a dominant intratubular component and a small cisternal component. The main disadvantage to this approach, is the need to involve the temporal lobe of the brain, which can lead to postoperative seizures.

Translabyrinthine approach. This is an approach through the inner ear, which is suitable for patients with large tumors and a lack of normal hearing. The advantage is that the facial nerve can be easily protected and the cerebellum does not need to be displaced. However, the approach to the contents of the jugular foramen and lower foramen magnum is limited.

The healthcare professionals in Germany take an individual approach to the planning of the operation in order to obtain the best functional outcomes, reduce health risks, and at the same time, achieve the goals of the surgical intervention.

To undergo your acoustic neuroma diagnostics and treatment in one of the German hospitals, you are welcome to make your appointment using the Booking Health service. Our website offers the actual prices that are relevant at the moment. Due to the absence of additional coefficients for foreign patients, the cost of making your treatment appointment through our service is lower than when contacting the clinic directly. The specialists of the Booking Health company will help you to choose the most suitable clinics in Germany for your acoustic neuroma treatment and organize your trip.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

Mayo Clinic

Healthline

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