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R. Sterling Hodgson, M.D.
1849 NW Kearney Street, Suite 200
Portland, OR 97209

Office: 503.553.3664
Fax: 503.553.3668

Vestibular Schwannoma & Skull Base Surgery

An vestibular schwannoma, formerly known as an acoustic neuroma, is a benign tumor growth that occurs on the nerve for hearing and balance function, between the inner ear and the brainstem. It is very slow growing and most often presents with gradual hearing loss and/or tinnitus (ringing in the ear), but sometimes may cause subtle disturbances of equilibrium or outright dizziness. The hearing loss is typically in the higher frequencies and might be harder for the individual to notice until it becomes more severe. Occasionally, a sudden loss of hearing might occur, prompting more immediate attention and evaluation. A history, physical examination and audiogram (hearing test) are needed to suspect a vestibular schwannoma. Its presence is best detected with an MRI scan. Rarely, a CT scan can be used to identify these lesions if an MRI is contraindicated, such as in patients with pacemakers or other medical implants that are not compatible with the magnetic fields used in MRI scans.

Traditionally, surgical removal has been the treatment of choice, but often at the expense of residual balance or hearing function in the affected ear. Hearing conservation techniques are available, but depend on the size and location of the tumor for success. Hearing does not improve with removal, a common misperception in many cases. Also, newer techniques in radiation treatment have emerged as viable alternatives to surgery. The goal of radiation is to prevent further growth of the tumor and preserve as much hearing and balance function as possible, but the tumor does not shrink significantly or resolve. Follow up scanning is necessary to document stability of the tumor in this situation. Vestibular schwannoma are uncommon and usually occur in one ear only. A rare genetic variant exists that causes both ears to be involved, usually at a relatively young age. Consultation with a neurotologist is very important for a patient identified with a vestibular schwannoma.


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R. Sterling Hodgson, MD | | 503.553.3664
1849 NW Kearney St., Suite 200, Portland, OR 97209