Please enable JavaScript.
Coggle requires JavaScript to display documents.
Risks and Complications of Acoustic Neuroma Surgery and Its…
Risks and Complications of Acoustic Neuroma Surgery and Its Managements/Aftercare
Management / Aftercare of Surgery
Further assessments
Hearing tests
Speech tests
Imaging
At home recovery
Doctor will give specific instruction
Prescription for pain medication to help feel more comfortable
Get someone to help with chores, allowing patient to heal
2 weeks after recovery
Return to surgeon (first follow up visit) - remove any sutures or staples
Transition from narcotic pain medications to acetaminophen, depending on individual case
Some patient may be prescribed pain medications for up to a month to help manage discomfort
Ear & Hearing Care
Patient may feel clicking sound, pulsing, tinnitus, fullness in ear
Avoid some habits: not blowing the nose until confirms that incision wound is healed
Ear discomfort normal after surgery
Hearing will be monitored and suggested with appropriate management (e.g.: HAs or learning sign language to enhance communication)
Introduce to support group
Balance
Increase activity gradually
Do not lift anything heavier than 10 pounds, strain or bend at waist
Physical therapy: to regain balance, improve coordination and adapt to changes in hearing
Staying active to maintain strength and heal the body
Acoustic Neuroma
Overview
Acoustic neuromas are tumors that develop from the sheath of Schwann cells
Usually found on the eighth cranial nerve (vestibulocochlear nerve)
Acoustic neuromas may eventually grow large, placing pressure on areas of the brain responsible for balance, hearing, and facial expressions if left untreated
Type of surgery
The retrosigmoid approach
The most common and effective method
The surgeon assess the tumor through an incision and bone opening behind the ear
Allows the surgeon to remove tumors of different sizes
May allow patient to keep their hearing (based on the size)
The middle fossa approach
Optimal with smaller tumors found mostly within the internal auditory canal.
The surgeon making an incision above the ear
May preserve the patient hearing
The translabyrinthine approach
Used for patient who has large tumor
Surgeons make an incision behind the ear. Some inner ear bone must be removed to reach the tumor
Commonly used if when the patient has little or no hearing before the time of surgery
Treatments for AN
Surgery
More reserved for large tumors (more than 3 cm in diameter)
Radiosurgery
Effective option for patients whose tumor is not safely removable during surgery since the tumor is significantly adherent to the facial nerve
A small amount of tumor is left behind in surgery to protect the integrity of the nerve
Risks and complications of acoustic neuroma surgery
Dizziness and balance disturbance
Imbalance is prolonged in 30% of the patients
Until the normal balance mechanism in the opposite ear compensates for the loss in the operated ear.
Compensates for the loss in the operated ear.
Unsteadiness for several years
Particularly when fatigued
Though this is not very common.
Acoustic neuroma surgery
The balance nerve usually has been damaged by the tumor,
Its removal frequently results in improvement in any preoperative unsteadiness.
Remove part or all of the balance nerve
In some cases, to remove the inner ear balance mechanism
Facial paralysis / Facial nerve damage
Acoustic tumors are in intimate contact with the facial nerve
The nerve which controls movement of the muscles
Which also close the eyelids, as well as the muscles of facial expression.
Temporary paralysis of the face and
muscles which close the eyelids.
It is common
Following removal of an Acoustic Neuroma.
Facial weakness
May persist for six to twelve months
Infrequently there may be permanent residual weakness
Facial nerve damage
Usually only temporary
Most patients recover in several months to a year
Cerebrospinal fluid (CSF) leak which might lead to meningitis
Bacteria, viruses, and fungi can induce inflammation and infection if they enter the CSF through a leak.
CSF leaks are a known risk due to the tumor's proximity to the protective membranes and delicate brain structures.
Stroke or bleeding (rarely happens)
Bleeding can occur in the location where the tumor was removed, causing increased pressure within the skull or interfere with the surrounding structures
Alteration of blood arteries near the brainstem during surgery has a small chance of triggering a stroke.
Other nerve weakness
Resultant double vision,
Numbness of the throat
Weakness of the face and tongue
Weakness of the shoulder
Weakness of the voice
Difficulty swallowing.