When to operate a case of Acoustic Neuroma

A 49year old male presented with history of left ear tinnitus, decreased hearing, deviation of angle of mouth to right and incomplete closure of left eye of 5years duration. MRI scan showed 2.4 cm lesion in left CP angle cistern with extension into internal auditory meatus. In this case, one can opt for surgical approaches or stereotactic radiosurgery.

Stereotactic radiosurgery can be used for lesions less than 3cm. But the cost is around 1.4lakhs which was not affordable for the patient. In this case, excision was done by translabyrinthine approach at a cost of Rs.75000. Though the 7th nerve did not improve, the patient’s severe tinnitus stopped post op.