How is an auditory neuroma treated?

  Auditory neuromas are benign tumors that originate from the eighth cranial nerve. The eighth cranial nerve is divided into the cochlear nerve (for hearing) and the vestibular nerve (for balance), and most auditory neuromas originate from the vestibular nerve. The tumor grows slowly, about 2-3 mm per year, and about 70-80% of the entire patient population is growing, with the rest of the patients stopping or shrinking (in the case of very small tumors in the internal auditory canal).  At present, there are three types of treatment for auditory neuroma: 1) No treatment: If the tumor is small, limited to the internal auditory canal, and the hearing is better than 30-40dB, and the speech recognition rate is better than 50%, no treatment can be considered, only regular hearing and MRI examination and follow-up observation; 2) Surgical treatment: If the surgery is performed by an otorhinolaryngologist, there are two types of surgery according to whether the hearing can be preserved before surgery (1) hearing preservation surgery: transcranial middle fossa pathway or posterior sigmoid sinus pathway; (2) non-hearing preservation surgery: transcranial vagus pathway or posterior sigmoid sinus pathway.  3.Radiation therapy: such as gamma knife stereotactic therapy, mainly suitable for patients with tumor diameter less than 3cm, no cystic changes, systemic conditions (hypertension, diabetes, age over 70 years old, etc.) are not suitable for surgical treatment.  Therefore, the vast majority of patients with auditory neuroma need to undergo surgical treatment. The rate of total surgical resection is greater than 95%, and the rate of preservation of facial nerve function varies depending on the size of the tumor, with the smaller the tumor, the higher the rate of preservation. Overall, the rate of facial nerve function preservation at 1 year after surgery is about 95%. For patients with tumors smaller than 2.0 cm, the postoperative hearing preservation rate ranges from 25-60% when the surgery is completed in the hearing preservation style.