Acoustic Neuroma
Acoustic neuroma (vestibular schwannoma) is a benign Schwann cell tumour arising from the vestibulocochlear nerve (cranial nerve VIII) within the internal auditory canal. These tumours grow slowly — typically 1–2 mm per year — and progressively compress the cochlear nerve, facial nerve, and cerebellar structures as they expand toward the cerebellopontine angle.
Understanding Acoustic Neuroma
Although acoustic neuromas are non-cancerous and slow-growing, their location within the narrow bony canal of the internal auditory meatus means that even small tumours can produce significant neurological symptoms. As the tumour enlarges, it compresses the cochlear nerve causing hearing loss, the vestibular nerve causing balance disturbance, and eventually the trigeminal and facial nerves as it extends into the cerebellopontine angle. Left untreated, larger tumours can compress the brainstem and cerebellum, producing life-threatening hydrocephalus.
Early detection transforms the prognosis: small and medium-sized tumours are highly treatable with stereotactic radiosurgery, preserving facial nerve function and often remaining hearing. For international patients, Istanbul offers access to world-class Gamma Knife expertise with waiting times measured in days, not months, and at 60–70 per cent below UK and US private healthcare costs.
Treatment Options for Acoustic Neuroma
View All ProceduresGamma Knife Radiosurgery in Turkey
Gamma Knife radiosurgery is a non-invasive stereotactic procedure that delivers 192 intersecting cobalt-60 radiation beams to a single focal point inside the brain with sub-millimetre accuracy. Each individual beam is too weak to damage the tissue it passes through; only at the convergence point does the accumulated dose become therapeutically powerful enough to destroy a tumour or lesion, with no incision, no cutting, and no general anaesthetic required.
arrow_forwardCraniotomy (Brain Surgery) in Turkey
A craniotomy is the surgical opening of the skull to access the brain for the removal of tumours, clipping of aneurysms, resection of arteriovenous malformations (AVMs), or decompression of swollen brain tissue. A bone flap is temporarily removed, the intracranial procedure is performed under microscope guidance, and the bone is secured back in place at closure. It remains the definitive approach for lesions that cannot be treated with less invasive methods such as Gamma Knife radiosurgery.
arrow_forwardSymptoms of Acoustic Neuroma
The earliest and most consistent symptom of acoustic neuroma is unilateral sensorineural hearing loss, typically gradual in onset but occasionally sudden. Patients describe a sensation of fullness in one ear, difficulty understanding speech in noisy environments, and high-frequency hearing loss that may go unnoticed for months. Tinnitus in the affected ear is present in over 70 per cent of patients. Vestibular symptoms including dizziness, unsteadiness, or true vertigo occur but are frequently misattributed to inner ear disorders. As the tumour grows, facial numbness or tingling, altered taste sensation, and eventually facial weakness may develop.
Diagnostic Pathways
MRI with gadolinium contrast is the definitive diagnostic tool. Acoustic neuromas enhance brightly and can be detected when still only a few millimetres in size. Tumours confined to the internal auditory canal (intracanalicular) are classified as small; those extending into the cerebellopontine angle are classified by Koos grade I–IV based on size and brainstem compression. Pure tone audiometry and speech discrimination testing quantify the functional hearing loss and help guide treatment decisions. Auditory brainstem response (ABR) testing can detect retrocochlear pathology and is sometimes used as a screening tool.
Advanced Treatment Options at Vellum Select
Vellum Select offers the full spectrum of acoustic neuroma management through Prof. Dr. Türker Kılıç, a leading neurosurgeon with extensive experience in both Gamma Knife radiosurgery and microsurgical resection for vestibular schwannomas.
Gamma Knife Radiosurgery
For small to medium-sized tumours (Koos I–II, typically under 3 cm), Gamma Knife Radiosurgery in Turkey is the preferred first-line treatment. Gamma Knife delivers 192 precisely focused beams of radiation to the tumour margin in a single outpatient session, arresting growth with sub-millimetre accuracy. Tumour control rates at five years exceed 95 per cent. Facial nerve preservation is above 98 per cent, and serviceable hearing is preserved in 60–70 per cent of patients. No incision, no hospital stay, and most international patients return home within 48 hours.
Microsurgical Resection
For large tumours (Koos III–IV) causing significant brainstem compression or hydrocephalus, or when hearing preservation is not feasible, Craniotomy (Brain Surgery) in Turkey via a retrosigmoid or translabyrinthine approach is performed. Prof. Dr. Kılıç utilises intraoperative neuromonitoring to maximise facial nerve preservation. Post-operative Gamma Knife is often used to treat any residual tumour adherent to the facial nerve, combining the best of both modalities.
To discuss your acoustic neuroma diagnosis with Prof. Dr. Türker Kılıç, view his profile or contact Vellum Select to arrange a consultation.
