Therapy & treatment of acoustic neuroma: «Watch and Wait»

After the diagnosis of an «acoustic neuroma» not acting, in other words choosing and starting no treatment, only waiting, without a concept, would be foolish. What are you waiting for? For the acoustic neuroma to actually shrink by itself, for the symptoms to subside or even to disappear, belongs to the still inexplicable events, whose frequency or rather rarity cannot even be expressed in numbers. As described on other pages of this website, an acoustic neuroma grows slowly, not steadily and uniformly, but it grows. The tendency is pre-existing that the complaints due to the acoustic neuroma will increase and at one point can become critical. Moreover, with time you lower the chance that the tumour can be removed without lasting damage to the cranial nerves.

To hold off one of the treatments to combat the tumour can only make sense under certain circumstances and for a specific group of patients. Sometimes the acoustic neuroma is detected by accident through another diagnosis. The acoustic neuroma patient does not feel any symptoms whatsoever. Or individual symptoms appear only faintly and sporadically and do not present any impairments for the patient. Or the patient's health, family or professional situation means that an acoustic neuroma operation can in no way be arranged (in the latter case, the complaints from the acoustic neuroma should still be very slight.).

In these cases action must not be taken immediately. However, at the same time two things are essential: first of all, a risk assessment by the doctor giving specific reasons for delaying the start of treatment. This assessment is discussed with the patient. Secondly, there must be constant monitoring of the tumour's behaviour.

This monitoring must be carried out by the doctor and the patient together. The doctor must create a close network of MRT images, and the patient must record everything very sensitively, which could possibly lead back to the existence and growth of the acoustic neuroma (e.g. increasing hearing loss, vertigo, ear noise, numbness in the face, frequent headaches). Only then is it guaranteed that it is not useless, or even damaging waiting, but rather that the start of treatment should only be delayed without any date being missed. Currently, this strategy is labelled differently: watch and wait, wait and see.

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