Acoustic neuromas may be discovered when the tumor is small or incidentally, when an MRI is performed to evaluate another condition. Since acoustic neuromas are benign tumors and may not be causing symptoms, careful observation over time, potentially over years, may be appropriate for some patients. Some patients will never require treatment for the tumor.
Observation may be appropriate for small tumors, older patients, and patients for whom treatment carries greater risk. Observation over time will be used to determine the growth rate of the tumor and changes in symptoms. If it appears that the tumor will not need to be treated during the patient's normal life expectancy, treatment and its potential complications may be avoided. If the tumor grows, or is causing symptoms, treatment may become necessary.
Patients with a tumor in their only hearing or better hearing ear may also consider careful observation, particularly when the tumor is of a size that hearing preservation with treatment would be unlikely.
With observation, MRI is used to track any tumor growth. Your doctor will determine the frequency of scans. In rare cases, an acoustic neuroma may shrink on its own. Treatment is recommended if either hearing is lost or threatened, symptoms begin to impair quality of life, or the tumor size becomes life-threatening.