Acoustic Neuroma / Cerebellopontine Angle (CPA) Tumor

The cerebellopontine angle is a space in the posterior fossa of the brain that contains the seventh and eighth cranial nerves as they course towards the internal auditory canal. The most common intracranial tumors that arise in this location are vestibular schwannomas (also known as acoustic neuromas) and meningiomas. Both vestibular schwannomas and meningiomas are benign tumors. Vestibular schwannomas typically arise from the vestibular segment of the eighth cranial nerve. The most common symptoms from tumors in this location include: hearing loss, tinnitus, balance dysfunction. Larger tumors may also result in numbness of the face due to compression of the fifth cranial nerve.

The best test for diagnosis of cerebellopontine angle tumors is a high resolution MRI scan of the inner ear with gadolinium contrast. Imaging characteristics often help differentiate between vestibular schwannomas and meningiomas.

There are three main treatment options for the management of vestibular schwannomas:

  1. Continued observation of tumor with annual MRI scans to assess tumor growth
  2. Stereotactic radiosurgery – highly focused radiation therapy to arrest the growth of the tumor. Dr. Mehta is certified in Gamma Knife radiosurgery and performs radiosurgery treatments at the San Diego Gamma Knife Center.
  3. Surgical removal of the tumor with microsurgical techniques. Because of the complex skull base anatomy in this location, surgical removal is performed as a team approach with a Neurotologist / Skull Base Surgeon and a Neurosurgeon. Dr. Mehta works closely with highly trained neurosurgeons in a multidisciplinary team approach to microsurgical resection of cerebellopontine angle tumors. As a facial nerve specialist, Dr. Mehta is particularly interested in preserving the best possible facial nerve outcomes for patients undergoing microsurgical removal of acoustic neuromas.