Matthew Stafford’s wife, Kelly, announced that she is pursuing surgery to remove a benign brain tumor. While she did not specify the type of tumor she has (and the public has no business knowing), she has mentioned she has experienced “vertigo” (the sensation of the room spinning) prompting her MRI imaging. The “tumor (is) sitting on some of my cranial nerves”. She also mentioned she is concerned about face weakness and hearing loss from the surgery.
The vestibulocochlear nerve or the “eighth” cranial nerve is a nerve that controls hearing and balance. A particular type of benign tumor, called an acoustic neuroma or schwannoma, can form on this nerve and cause hearing loss, ringing in the ears and balance trouble. If the tumor becomes large enough, it can also start causing pressure on the “seventh” cranial nerve, or facial nerve, which can lead to face weakness. In certain circumstances, the tumor presses on the brainstem.
Most acoustic neuromas can be observed. Often they are small and we do not intervene unless the tumor causes “functional” hearing loss, debilitating ringing in the ears or balance trouble, the tumor shows signs of enlargement on follow-up imaging, or the tumor is compressing the brainstem.
If the tumor is small, but requires intervention, a special type of radiation, called stereotactic radiosurgery, can sometimes be used. This may be called gamma knife or cyberknife. This may cause facial weakness or hearing loss. The rate of facial strength preservation is about 94%. The rate of hearing preservation ranges widely from 32-81%.
In larger tumors, radiation may not adequately shrink the tumor and a surgical procedure may performed in which part of the skull is removed to resect the tumor. Monitoring of the facial and vestibulocochlear nerves is performed but there still may be a higher risk of facial weakness and hearing loss. Only about 63% of patients have preserved face strength. Only about 29% have hearing preservation.
There are other benign tumors in this region, which can cause similar symptoms, such as meningiomas. At RMBSI, we evaluate and treat tumors around the cranial nerves such as acoustic neuromas and meningiomas.
References
1. Han JH. Hearing outcomes after stereotactic radiosurgery for vestibular schwannomas: mechanism of hearing loss and how to preserve hearing. Adv Tech Stand Neurosurg. 43:3-36, 2016.
2. Kaylie DM. Acoustic neuroma surgery outcomes. Otol Neurotol. 22(5):686-689, 2001
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