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Skull Base Lesions

Skull base lesions vary in size, location, and severity based on the particular diagnosis. Fortunately, at MUSC Health we are uniquely qualified to treat all skull base lesions. We take an individualized team approach to every patient often working with our colleagues in neurosurgery, head and neck oncology, and radiation oncology to provide outstanding outcomes. Treatment options include observation with serial imaging, stereotactic radiosurgery, and microsurgery. We are equipped to provide the most up to date diagnostic testing and treatment for all skull base lesions.

Some skull base lesions we treat:

Acoustic Neuroma

Acoustic neuroma, also referred to as vestibular schwannoma, is a noncancerous tumor that may develop from an overproduction of Schwann cells that press on the hearing and balance nerves in the inner ear. Schwann cells are cells that normally wrap around and support nerve fibers. If the tumor becomes large, it can press on the facial nerve or brain structure.

What are the Symptoms of Acoustic Neuroma?

The following are the most common symptoms of acoustic neuroma. However, each individual may experience symptoms differently.

When a neuroma develops, it may cause any or all of the following:

  • Hearing loss
  • Feeling of fullness in the ear
  • Tinnitus, A ringing in the ear
  • Dizziness
  • Balance problems
  • Facial numbness and tingling with possible, though rare, paralysis of a facial nerve
  • Headaches, clumsy gait, and mental confusion may be life-threatening conditions and require immediate treatment

The symptoms of acoustic neuroma may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

Different Types of Acoustic Neuromas?

There are two types of acoustic neuromas:

  • Unilateral acoustic neuromas. This type affects only one ear. This tumor may be diagnosed at any age, but most often between the ages of 30 and 60.
  • Bilateral acoustic neuromas. This type affects both ears and is hereditary, caused by a genetic disorder called neurofibromatosis-2.

Diagnosis of Acoustic Neuromas

Because symptoms of acoustic neuromas resemble other middle and inner ear conditions, they may be difficult to diagnose. Preliminary diagnostic procedures include an ear examination and a hearing test. Magnetic resonance imaging scans (MRI) help to determine the location and size of the tumor.

Early diagnosis offers the best opportunity for successful treatment.

Treatment for Acoustic Neuroma

Specific treatment for acoustic neuroma will be determined by your MUSC Health neurotologist based on:

  • Your age, overall health, and medical history
  • Tumor size
  • Hearing ability
  • Expectations for the course of the disease
  • Your opinion or preference

Treatment may include observation, surgery, or radiation. Your MUSC Health neurotologists have all received specialized training to manage acoustic neuromas.

Meningioma

A meningioma is a type of tumor that's often discussed along with brain tumors, though it's not technically a brain tumor. This type of tumor grows in the meninges, which are layers of tissue that cover the brain and spinal cord.

These tumors are usually benign. This means that unlike cancerous tumors, they don't tend to spread to distant parts of the body. Because of their location, though, meningiomas can still cause neurological problems. As these tumors grow, they can compress the brain and spinal cord, leading to serious symptoms.

Facts About Meningioma

Meningiomas are the most common type of brain tumors in adults and occur more often than cancerous brain tumors. Children rarely get them, and they're more common in older adults. Women are also much more likely to get them than men. The underlying cause of meningiomas is not clear. Hormonal fluctuations may encourage the growth of these tumors, but more research is needed to confirm this.

Symptoms of Meningioma

These tumors usually grow slowly. You may not have any symptoms until the tumor has become large. The tumor can cause different symptoms, depending on where it's growing. These are possible symptoms:

  • Vision or hearing loss
  • Seizures
  • Trouble thinking clearly
  • Trouble walking
  • Loss of smell
  • Weakness in an arm or leg
  • Headache
  • Nausea

Diagnosis of Meningioma

Doctors often diagnose a meningioma using an MRI or CT scan. In addition, the doctor may want to remove a sample of the tumor to examine it under a microscope before making the diagnosis.

Treatment of Meningioma

If your meningioma is causing symptoms or is growing, your doctor will likely want to remove it with surgery. In some cases, though, trying to remove the tumor may be too risky. For example, the tumor may be too close to a vital brain structure or blood vessel.

If you do have surgery, the surgeon will try to take out as much of the tumor as possible. The surgeon may use MRI images of your brain to help guide the surgery. The surgeon may also use a special microscope during the surgery to get a better view of the tumor and the surrounding parts of your brain.

If the surgeon can't remove the tumor—or can only remove part of it—you may need radiation therapy. Depending on the areas of the brain and/or spinal cord that are involved, radiation therapy may help shrink any remaining tumor and can also prevent it from spreading to the tissues around it. Even if the tumor is completely removed during surgery, some doctors may still recommend radiation therapy to help prevent another meningioma from developing in the future. Meningiomas have a tendency to grow back after surgery.

Your doctor may also recommend medications to treat the tumor. Experts are studying several drugs to see if they work against meningiomas. You may need to take part in a study in order to use these drugs.

You may also be able to use other drugs to treat symptoms caused by the meningioma, such as seizures, excessive vomiting, weakness, and vision disturbances.

Long-Term Management Of Meningiomas

In most people, meningiomas don’t cause any symptoms and grow quite slowly. For this reason, doctors will recommend using an approach called “watchful waiting.” This means you will report any new symptoms to your doctor, and your doctor will order scans on a regular basis to track even minor changes in the tumor. This may be a reasonable option for managing small tumors that aren't causing symptoms, especially in older adults who may not be able to undergo surgery or radiation therapy because of other medical conditions.