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Watchful Waiting for Acoustic Neuroma

Acoustic neuromas, also called vestibular schwannomas, often grow slowly, and sensitive MRI scans help doctors find most of them while they’re still small. Specialists at NYU Langone may recommend watchful waiting, a period during which you’re carefully monitored and treated conservatively. The average growth rate of this type of tumor is 1 to 2 millimeters each year, but it can vary, with periods or more or less growth.

Watchful waiting can continue for years, and some people may never require treatment. Rarely, an acoustic neuroma may shrink on its own.

While the frequency varies, people with an acoustic neuroma may have an MRI scan at least once a year to determine whether the tumor has grown. The doctor may also ask about symptoms, such as tinnitus, or ringing in the ears; hearing loss; and balance problems. If the tumor has grown or symptoms have developed, your doctor may recommend either surgery or radiosurgery—the use of energy beams to destroy tumor cells.

Over time, watchful waiting carries a risk of the tumor growing, as well as hearing loss, increased tinnitus symptoms, or other symptoms such as balance problems. Doctors usually recommend treatment for young people, who are likely to experience complications of the tumor at some point in their lives and who can tolerate treatment well. For older people in poor health, the risks of treatment may outweigh the benefits, and watchful waiting may be a better option.

Regardless of your age or whether your tumor has grown, however, you may opt for treatment if ongoing symptoms or the knowledge of a growth in your head are significantly affecting your quality of life.

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