Acoustic Neuroma Microsurgery

What you should know

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.

Getting Ready

The week before your surgery:

  • Ask someone to drive you home when you are ready to leave the hospital. Do not drive yourself.

  • Your caregiver will examine your ears, nose, and throat, to check for any problems. Talk to your caregiver about your symptoms and how long you have had them. Let your caregiver know if you have any family members with similar problems.

  • You may need to have blood and urine tests and an electrocardiogram (ECG). You may need a CT scan or an MRI. You may also need an x-ray of your neck. You may need an audiometry hearing test and a speech discrimination test. You may also need tests to check how well your heart and lungs function. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • Medicines:

    • Antibiotics: Antibiotics given to you before your surgery will help prevent infection.

    • Steroids: Steroids decrease inflammation.

Treatment

What will happen:

  • You will be taken to the room where your surgery will be done. General anesthesia medicine will be given to keep you asleep and free from pain during your surgery. The hair on the side of your head to be operated on will be shaved.

  • 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 (hole) will be 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.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You get sick (a cold or flu) or have a fever.

Seek Care Immediately if

  • You suddenly have facial numbness or cannot move parts of your face.

  • You suddenly have a severe headache.

  • Your hearing loss worsens suddenly.

  • Your vision has worsened.

© 2014 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.

Hide
(web2)