Acoustic Neuroma

Acoustic neuroma can affect facial sensation, expression, and balance. Lasik is not normally directly affected by this malady

Acoustic neuroma is not usually a contraindication for conventional or custom wavefront  Lasik,  Bladeless Lasik, PRK, LASEK, Epi-Lasik, P-IOL, or RLE if it has been either removed or otherwise stabilized, however be sure to tell your doctor about your condition before having refractive surgery.

Acoustic neuroma (sometimes termed a neurolemmoma or schwannoma) is a non-cancerous tissue growth on a nerve leading from the brain to the inner ear. This nerve both transmits sound information and sends balance information to the brain from the inner ear. Although reduced facial sensation, limited facial expression, and poor balance may occur, these do not directly affect refractive surgery, a concern would be if these symptoms developed after Lasik or similar laser eye surgery it would be difficult to determine if the symptoms were related to the surgery or acoustic neuroma.

The affected nerve to the ear and the facial nerve that provides motion of the muscles of facial expression lie adjacent to each other as they pass through a bony canal called the internal auditory canal. The brain is not invaded by the tumor, but the tumor pushes the brain as it enlarges. The slowly enlarging tumor protrudes from the internal auditory canal into an area behind the temporal bone called the cerebellopontine angle. The tumor now assumes a pear shape with the small end in the internal auditory canal.

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Recent Acoustic Neuroma Medical Journal Articles...

Related Articles

Retrosigmoid versus translabyrinthine approach to acoustic neuroma resection: A comparative cost-effectiveness analysis.

Laryngoscope. 2015 Oct 22;

Authors: Semaan MT, Wick CC, Kinder KJ, Stuyt JG, Chota RL, Megerian CA

Abstract
OBJECTIVES/HYPOTHESIS: Approach-specific economic data of acoustic neuroma (AN) resection is lacking. The purpose of this study was to analyze and compare adjusted total hospital costs, hospital and intensive care unit (ICU) length of stay (LOS), and associated factors in AN patients undergoing resection by translabyrinthine (TL) approach versus retrosigmoid (RS) approach.
STUDY DESIGN: Retrospective chart review.
METHODS: A total of 113 patients with AN undergoing TL (N = 43) or RS (N = 70) surgical resection between 1999 and 2012 were analyzed. Data including age, health status, preoperative hearing, tumor size, postoperative complications, hospital, ICU LOS, and disposition after discharge were collected from medical records and compared between both groups. Cost data was obtained from the hospital finance department and adjusted based on the Consumer Price Index for 2013.
RESULTS: There were no significant differences in demographic data, preoperative hearing, preoperative health status, or postoperative complication rate. Total hospital LOS and ICU LOS were significantly longer in the RS compared to the TL group (4.3 ± 3.6 vs. 2.6 ± 1.1 days; P < 0.001, and 1.5 ± 1.1 vs. 1.0 ± 0.5 days; P = 0.015, respectively). Tumors were larger in RS compared to the TL group (2.1 ± 1.0 cm vs. 1.5 ± 0.7 cm, respectively; P = 0.002). When patients were stratified by tumor size < or ≥ 2 cm, the total hospital LOS remained greater in the RS group in both subgroups (< and ≥ 2 cm, P < 0.001, and P = 0.031, respectively). However, there was no difference in the total ICU LOS between both subgroups. The adjusted mean total hospital cost was higher in the RS compared to the TL group ($25,069 ± 14,968 vs. $16,799 ± 5,724; P < 0.001). The adjusted mean total hospital cost was greater in the RS group with tumor < 2 cm (P < 0.001) but not significantly different in patients with tumors ≥ 2 cm. Univariate analysis showed that greater tumor size, poorer preoperative health status, the presence of major postoperative complications, and the RS approach were independently significantly associated with higher total hospital LOS (P = 0.001, P = 0.009, P = 0.001, and P < 0.001, respectively) and a higher adjusted total hospital cost (P < 0.001, P = 0.002, P = 0.014, and P < 0.001, respectively).
CONCLUSION: Hospital LOS and total adjusted costs are significantly less for patients undergoing translabyrinthine acoustic neuroma resection compared to the retrosigmoid approach. Many factors appear to influence these differences. Economic considerations in addition to tumor characteristics and surgeon preference should be considered in future acoustic neuroma resections.
LEVEL OF EVIDENCE: 2c. Laryngoscope, 2015.

PMID: 26490680 [PubMed - as supplied by publisher]