Acoustic Neuroma Microsurgery

WHAT YOU SHOULD KNOW:

Acoustic Neuroma Microsurgery (Inpatient Care) Care Guide

Acoustic neuroma microsurgery is surgery to remove an acoustic neuroma (AN). AN is a slow growing tumor that forms on the nerves of your ear. The nerves help control your balance and hearing.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • The anesthesia medicine used for your surgery may cause an allergic response. Surgery may cause you to have an infection, and you may bleed more than expected. Your brain, eyes, bones, blood vessels, or nerves may also get injured. If a nerve is injured, you may need to have another surgery to repair it. You may have trouble controlling and moving your facial muscles, or lose feeling in your face. You may suffer from hearing loss, headaches, tinnitus, trouble seeing, or problems with balance. Cerebrospinal fluid (CSF) from your brain may leak out of your surgery site or from your nose. Surgery may cause you to have a stroke, or may even cause death.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • If your tumor is not completely removed during surgery, it may grow back. If you do not have surgery to remove your tumor, it may continue to grow. Your hearing loss, vertigo, tinnitus, balance problems, and headaches may get worse. Without surgery, you may also lose your hearing completely. Fluid may build up around your brain, and areas of your brain may be compressed (pushed on). You may have trouble walking or moving. Your vision (sight) may become poor, and you may have a trouble swallowing or tasting your food. Ask your caregiver if you have questions about your condition, surgery, or care.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Vital signs: Caregivers will monitor your vital signs during your surgery. This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). An arterial line may be placed for measuring your blood pressure. An arterial line is a tube that is placed into an artery (blood vessel), usually in your wrist. The arterial line may also be used for taking blood.

During your surgery:

  • Your caregiver will make a C or U-shaped incision (cut) behind or above your ear. The hard tissue that covers your skull is cut and secured out of the way. An opening is made in your skull using special tools. A part of your skull may be removed to help your caregiver see your inner ear. The protective covering of your brain will be opened and moved aside. Bones of your inner ear and behind your ear may also be removed. Monitoring will be done to decrease the risk of damage to your nerves and other areas of your brain. Special tools will be used to carefully remove your tumor.

  • After your tumor has been removed, your caregiver may choose to use a tool called an endoscope. An endoscope is a thin, bendable tube with a tiny camera and light source on its end. It will be inserted through the opening in your skull to check for any remaining tumor tissue. The endoscope may also show any areas that are bleeding and need to be fixed. Muscle or abdominal fat may be used to fill in the area where your bone and tumor were removed. The protective covering of your brain will be closed with a special glue or stitches. If a piece of your skull bone was removed for surgery, it will be put back and secured. The tissue covering of your skull, and your skin will then be closed with stitches.

After your surgery:

A tight bandage will be placed over your incision to prevent bleeding. The bandage will also help keep the area clean and dry to prevent infection. You will be taken to a room or an intensive care unit (ICU). Caregivers will watch you closely for any problems. Do not try to get out of bed until your caregiver says it is OK. Your caregiver may remove the bandage shortly after surgery to check your incision. Within one week you may have an audiometry test and CT scan to check how you are doing.

  • Activity: You will need to stay in bed for one day after your surgery. On day two after your surgery, your caregivers may help you get out of bed to move around. A therapist may work with you on exercises to decrease dizziness and improve your balance.

  • Lumbar drain: A lumbar drain may be needed after your surgery if you have a CSF leak. The drain will remove any leaking fluid from the area around your spinal cord. Ask your caregiver for more information about a lumbar drain.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

  • Neurologic signs: Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your eyes, your memory, and how easily you wake up. Your hand grasp and balance may also be tested. This helps tell caregivers how your brain is working after your surgery. You may need to have your neuro signs checked often.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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