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Acoustic tumors are tumors of the balance and hearing nerves, which are situated between the inner ear and the brain.
Acoustic neuroma can be difficult to diagnose because the symptoms are similar to those of middle ear problems.
Early diagnosis of a vestibular schwannoma (acoustic neuroma) is key to preventing its serious consequences. Microsurgical removal is usually recommended in healthy people with growing tumors or when the tumor is very large and there are no other options. Dr.Maw has extensive training and experience in performing microsurgery for the removal of acoustic neuromas.
The Translabyrinthine Approach: In this approach, the surgeon works through the inner ear, or labyrinth, to remove the tumor.
The Retrosigmoid Approach: In this approach, the tumor is exposed via entering the skull and opening the dura mater (a craniotomy) behind the ear. The Middle Fossa Approach: In this approach, the tumor is exposed through the skull above the ear and the temporal lobe of the brain is lifted and gently retracted to access the location of the tumor. Stereotactic radiation (gamma knife or LINAC) is considered as a treatment option in many patients and is likely the best treatment option in sick or elderly patients with growing tumors who need treatment. Although there are two main forms of vertigo, Central Vertigo and Peripheral Vertigo, the latter, Peripheral Vertigo, is by far the most severe form of the condition.  The disorder is caused by an imbalance in the delicate inner ear, which controls the body’s balance and there are four main forms of this troubling condition. This then causes a sensation of disorientation within the central nervous system which causes the feeling of dizziness within the afflicted person. Other causes of BPPV include post-viral infection, chronic middle ear disease, head injury, and spontaneous degeneration of the labyrinth. This form of the condition causes dizziness along with a sensation of perpetual motion even when the sufferer is standing or sitting still. This disorder occurs because of an inflamed labyrinth, a delicate structure in the inner ear, which, when damaged has the potential to seriously affect both hearing and balance.  The condition can be caused from either a bacterial infection, or a viral infection such as a cold or the flu, that latter of which is more common. Like BPPV the symptoms of Labyrinthitis pass within a few weeks in most cases but of course, sufferers of this uncomfortable condition will want to learn how to best manage and treat their symptoms. Bed rest –  Research has shown plenty of bed rest enables the body’s immune system to repair itself more effectively, and regular and adequate rest will undoubtedly help sufferers to cope better with their Labyrinthitis. Vestibular Rehabilitation Treatment (VRT) – This treatment works by attempting to rewire the brain into coping more effectively with the altered signals that it receives from the vestibular system as a result of Labyrinthitis. Drinking plenty of water – Ensuring the body receives enough fluids will prevent sufferers from becoming dehydrated which can lead to a worsening of symptoms. Lying still – During an onset of Labyrinthitis, it is best to lie as still as possible until the most severe symptoms pass.   Research has shown that lying on one side is the most beneficial position for easing symptoms.
Also sufferers should avoid bright lights, smoking, chocolate, and alcohol, as these can all trigger an attack. Also called Vestibular Neuritis, this form of the condition comes on suddenly and is typically triggered by an infection that has spread to the vestibular nerve, which affects balance.
A virus such as the herpes simplex virus can trigger an attack, and, as a result of this, the most effective treatment would be to medicate the virus with drugs that target the underlying condition.   If herpes is the cause for example, then the drug prescribed would be Acyclovir, a drug typically used to treat herpes simplex. Common symptoms of Vestibular Neuronitis include, unsteadiness when walking or standing, earache, vomiting, and nausea, and the condition typically follows a viral infection such as a cold.  The good news is that attacks are typically a one-time occurrence, with up to 95% of successfully treated patients never suffering a recurring bout of the condition. Vestibular rehabilitation exercises have been proven to be effective in the treatment of the symptoms of this condition with the sufferer referred to a Vestibular Rehabilitation therapist who will evaluate the severity of the disorder.  After this evaluation, a full treatment plan will be drawn up that will consists of specialized balance exercises that are designed to correct and strengthen balance.

This form of Peripheral vertigo is a vestibular disorder that is caused by high inner ear fluid levels which causes a swelling in the delicate labyrinth of the inner ear.  An attack can last from between 20 minutes to several hours with the average being between two and four hours. There are a number of ways that this form of vertigo can be treated, depending on the severity and depth of symptoms experienced.
Sufferers of Menieres disease are also frequently prescribed a medication called betahistine, which helps by reducing pressure caused by fluid levels in the inner ear, relieving the uncomfortable symptoms of the condition.
If you suspect a diagnosis of Peripheral Vertigo then the first thing to do is visit a qualified medical practitioner to confirm diagnosis.  If you have already been diagnosed, following the advice in this guide will help you to best manage your individual form of the condition. Peripheral Vertigo is not typically treated with conventional medications, but, if your form of the condition is particularly severe, your doctor may prescribe a short course of prescription drugs, such as benzodiazepine or anti-emetics to suppress nausea and vomiting. Always make sure to see your doctor if you experience a worsening of symptoms or experience additional symptoms such as mental confusion or weakness or numbness in a part of your body as this could indicate a more serious medical condition. Superior Semicircular Canal Dehiscence (SSCD) is caused by a tiny hole that develops in one of the three canals inside the ear. The thinning or absence of bone in the semicircular canal triggers vertigo, hearing loss, disequilibrium and other balance and auditory symptoms. The symptoms of SSCD can get worse when a patient experiences extended episodes of coughing, sneezing or blowing of the nose.
Physicians use several auditory tests to detect and evaluate SSCD, including high-resolution computed tomography (CT) and vestibular-evoked myogenic potentials (VEMP). VEMP is used to test the responses of the inner ear and confirm a suspected presence of SSCD. For patients with mild to no symptoms, it is best to take a conservative approach and simply avoid symptom triggers.
Surgical repair of SSCD includes skull-base middle-fossa craniotomy for canal-repair resurfacing, plugging or capping the bony dehiscence. Rhino Calci-Bears are sour gummy bear supplements that are a great way for kids to get the calcium they need.
These tumors sometimes do grow to a large size while causing few symptoms because they grow very slowly. An MRI scan with gadolinium is the gold-standard test in the diagnosis of acoustic neuromas. The surgery is a fairly extensive operation performed over several hours and requiring observation after surgery in the intensive care unit for on average 1-2 days. She completed a prestigious fellowship at the Michigan Ear Institute which is one of the world’s largest centers for acoustic neuroma treatment. The most significant are the size of the tumor and the level of hearing in the affected ear. The patient is totally and permanently deaf after this operation, however there are advantages to this procedure that warrant considering this approach even is the patient has residual hearing in the ear before surgery.
The back of the brain, or cerebellum, is retracted to gain access to the location of most tumors.
The advantage of this approach is the potential ability to preserve hearing and is often chosen in the setting of healthy patients with small tumors and good hearing.
Labyrinthitis is usually triggered by an inner ear infection and because of this it can occur alongside other symptoms such as fever, nausea, and earache.
Steering clear of stressful situations and cutting out intrusive noises is also highly recommended. Healthy individuals have two holes or "mobile windows" in their dense otic capsule bone, but those with SSCD have developed a third hole.

A common symptom of SSCD is the abnormal amplification of internal body sounds such as heartbeats and eye movements.
VEMP is important in determining if it is SSCD that is causing conductive hearing loss rather than a true ossicular disease. Patients with primarily pressure-induced symptoms can have a tympanostomy tube placed, but this is not effective for all patients. There are always risks associated with surgery, but most patients report a high level of improvement after surgical treatment. We recommend that you do not rely solely on the information presented and that you always read labels, warnings, and directions before using or consuming a product.
Other testing is usually performed after diagnosis to assist in the decision regarding treatment. Removal of some bone is usually required while working within the open dura mater, and this can be a source of headache after surgery. When extensive, they can press against the brain and other nerves.At first, you may have no symptoms or mild symptoms. Maw believes in a team approach to this delicate procedure and usually performs the surgery with the assistance of a neurosurgeon. As the tumor grows larger, surgical removal is more complicated and hearing and balance may be lost. There us usually less stretch and injury to the facial nerve and the facial nerve function results are usually excellent. Hearing preservation generally depends on the size of the tumor, but is still not guaranteed even with very small tumors. The condition is usually diagnosed in middle age, although it has been seen in small children. The facial nerve accompanies the nerves of hearing and balance along their course from the brain through the ear and this is a very important nerve to protect during microsurgery. As most of the exposure of the tumor with this procedure occurs outside of the envelope for the brain, the dura mater, there is less post-operative headache and so this is often a good choice of approach for patients who suffer from migraine or other headaches. The surgeon also gains ample access to the area where the tumor is in contact with the brain, and is a good choice in patients with large tumors or when the tumor is not an acoustic neuroma.
Maw, a neurosurgeon, an anesthesiologist, a specialist who monitors the cranial nerves during surgery and intensive care unit physicians and staff. The preservation of the facial nerve is of utmost importance, and is more of a priority than the patients hearing. If balance problems are present prior to surgery, this is often a good choice of surgery as it allows the abnormal balance function to be removed and the patient can then usually compensate and regain balance.
In some cases, the facial nerve is on the far side of the tumor with this approach, and stretching of this nerve is sometimes necessary to remove the tumor. If Observation is chosen, a repeat MRI scan is usually obtained in 6 months and then yearly if stable.
Another complication, spinal fluid leakage, is on average slightly lower with this approach.
The hearing may be lost in this approach, as patients with these tumors sometimes do have a rapid deterioration of hearing.

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06.11.2015 admin

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