A Patient's Guide to Acoustic Neuroma Surgery Recovery

Acoustic neuromas are a type of schwannoma, a slow-growing benign brain tumor. Schwannomas make up 8% of all intracranial tumor diagnoses. Bilateral acoustic neuromas account for 5% of all schwannomas, making them incredibly rare.

These tumors form on the cochlear or vestibular nerve in the brain. The cochlear nerve is responsible for hearing, while the vestibular nerve regulates balance and eye movements.

Acoustic neuromas are treatable with surgery. Many people experience new or worsening symptoms during acoustic neuroma surgery recovery, which can be scary if they don't know what to expect ahead of time.

We want to ensure you have a relatively comfortable and stress-free recovery process. So, this guide will explain what to expect from acoustic neuroma surgery and the post-operative recovery process.

Acoustic Neuroma Treatments

Though benign types of brain tumors, acoustic neuromas cause devastating symptoms, including hearing loss, tinnitus, vertigo, headaches, and facial numbness. When left untreated, these tumors can compress the brainstem.

Luckily, acoustic neuromas are slow-growing. When caught early, they may be small enough that the person has not developed any symptoms. Treatment may not be necessary yet.

Another situation where doctors may not want to treat a neuroma is if the patient is older and has one or more comorbid health conditions. Even if the tumor is large, the risks of treatment often outweigh the benefits.

In these cases, doctors will monitor the neuroma's growth and order one of the following interventions should symptoms begin to emerge.

Radiotherapy

Surgery was formerly the preferred treatment option for acoustic neuromas. However, tumors measuring less than three centimeters in diameter may not require surgery, making radiotherapy the better choice.

Radiotherapy may also be used in combination with surgery. For example, if a neuroma adheres to the facial nerve, surgeons will leave a piece behind to preserve the nerve's function. Radiotherapy will then be used to eliminate it.

Surgery

Tumors that are larger than three centimeters in diameter require surgery to remove. Some surgeons may also prefer surgery for the treatment of any acoustic neuromas causing brain tumor symptoms.

Types of Acoustic Neuroma Surgery

There are three approaches to surgery for acoustic neuromas, each with its own pros and cons. Learn about these three surgical approaches and when they are used next.

The Retrosigmoid Approach

Surgeons create a small surgical opening at the base of the skull to allow access to the cranial nerves. Though it works for any size tumor, only patients with smaller neuromas can hope to retain their hearing after surgery.

The Translabyrinthine Approach

Surgeons create a surgical opening behind the ear and remove a portion of the inner ear. This approach allows for the complete removal of even the largest tumors and can preserve the facial nerve, but it also leads to full hearing loss.

The Middle Fossa Approach

Surgeons create a small surgical opening above the ear and retract some of the brain's temporal lobe to get to the tumor. Only patients with small tumors can undergo this surgery, but their hearing will remain intact.

Acoustic Neuroma Surgery Recovery Timeline

Acoustic neuroma surgery is a major surgery. It may take a year or longer for you to heal and be symptom-free. Here's what to expect during that time.

Directly After Surgery

After undergoing surgery for an acoustic neuroma, you will have to stay in the hospital for three to five days. Hospital staff will monitor your progress for complications like spinal fluid leaks.

You may experience a sore throat from being intubated, headaches, nausea, or dizziness during this time. Your doctor may prescribe a pain medication for soreness or discomfort.

To ensure proper balance and reduce the risk of ongoing vertigo, you may undergo a vestibular rehabilitation program. You may also be instructed in facial exercises to help with nerve weakness.

Two Weeks Post-Op

By the time you have been in recovery for two weeks, you will have been moved home from the hospital. Your doctor will taper you off of prescription pain medication to over-the-counter painkillers like acetaminophen.

You will attend a two-week post-operation follow-up appointment. The doctor will remove your stitches and ask you about any symptoms you may be experiencing, such as headaches and continued facial palsy.

Six Weeks Post-Op

Most patients can return to work six weeks after acoustic neuroma surgery. Some doctors may recommend waiting 12 weeks, depending on your recovery progress.

By this point, most people will have stopped experiencing headaches. Their facial paralysis symptoms may also begin to improve as residual swelling subsides.

Your doctor will likely continue to place restrictions on physical activity. However, they may prescribe at-home exercises to ease discomfort or strengthen your facial muscles.

Three Months Post-Op

Doctors recommend avoiding flying on airplanes for the first three months after acoustic neuroma surgery. Three months gives the surgical incision time to heal.

Traveling on an airplane before three months have passed increases the risk of cerebrospinal fluid (CSF) leakage. CSF leaks are serious and can cause complications from decreased blood flow to the brain.

Six Months Post-Op

Most people are no longer under activity restrictions at six months following their surgery. You may experience mild lingering side effects, including hearing problems, visual disturbances, dizziness, headaches, or facial palsy.

However, these symptoms should be milder than they were directly after surgery. If you develop new or worsening symptoms, you should schedule a follow-up appointment with your doctor.

One Year Post-Op

Unless you experience complications, you should be fully healed in a year. You can resume all activities, including flying and intense exercise. Your symptoms will have resided.

Most people recover from temporary facial paralysis after a year following acoustic neuroma surgery. In rare cases, this symptom may continue and potentially require a second round of surgery.

Recovering from Brain Surgery: You're Not Alone

Acoustic neuroma surgery recovery may last for up to a year, but most people start feeling themselves after a few weeks. Symptoms like hearing loss and facial paralysis are usually temporary but may become permanent for some.

Are you searching for a brain tumor treatment center in Connecticut? CT Brain Tumor Alliance is here to support patients and their loved ones. Browse our resources to find leading acoustic neuroma surgery centers near you.