As it does for every patient, Kelly Stafford’s diagnosis of a brain tumor called an acoustic neuroma struck her with fear. The wife of NFL quarterback Matthew Stafford revealed during an interview with The Today Show that she was “completely terrified” at the prospect of brain surgery.
But it’s here, when patients are at their most vulnerable, that Melvin Field, MD, FAANS and medical director of AdventHealth's Minimally Invasive Brain Surgery Program, can offer the most hope.
“We have a good discussion about the many effective ways we can treat an acoustic neuroma that will give them a cure and a normal life,” says Dr. Field. After undergoing surgery in April, Stafford wrote on Instagram, “This Easter is the beginning of a new life for me.”
Many patients don’t require surgery at all, Dr. Field says. Especially if the tumor is small, a one-day, painless dose of radiation using a technology called Gamma Knife is usually enough to stop the tumor from growing.
No matter the treatment, a team approach that includes experts in brain surgery, inner ear disorders, radiation therapy and more offers the most promise for curing acoustic neuroma.
What’s an Acoustic Neuroma?
It’s a tumor that starts on the nerves that run between the inner ear and the brain. These nerves control our hearing and balance, which is why some of the first symptoms of an acoustic neuroma may be hearing problems and dizziness.
That’s how Stafford first noticed there was a problem.
“I would show my girls how to do a front roll or twirl in ballet class and immediately feel dizzy and off balance,” she wrote. “Things that I had been doing my entire life were now, all of a sudden, difficult.”
The tumor is not cancerous, meaning it will not spread to other parts of the body. But it can grow until it presses on other parts of the brain, causing more problems. Symptoms of an acoustic neuroma include the following:
- Facial Paralysis or Weakness
- Loss of Balance or Dizziness (Vertigo)
- Pain or Numbness in Face
- Ringing in the Ear
- Stroke-like Symptoms
Doctors don’t know why people with an acoustic neuroma develop the tumor. But there are effective treatments.
How Is it Diagnosed and Treated?
Like most people who are diagnosed with an acoustic neuroma, Stafford learned about the tumor after a MRI scan.
Still, as with many patients, it wasn’t easy to diagnose. Stafford first went to the emergency room where initial tests didn’t find an obvious explanation for her dizziness. It was only after continued balance problems that a doctor suggested a MRI. There are three main responses to an acoustic neuroma:
- Watchful Waiting: Fortunately, acoustic neuromas grow slowly. Returning for follow-up scans can reveal whether the tumor is growing.
- Gamma Knife: By precisely targeting gamma radiation at the tumor, this technology can kill it and prevent it from growing further.
- Surgery: Depending on the size and location of the mass, along with the patient’s goals and priorities, a surgical team can remove the tumor.
Dr. Field speaks with each patient about the benefits and risks of each option.
For example, some patients say they don’t want to risk the tumor growing and causing symptoms, but they don’t want surgery. Gamma Knife may be the right choice for them, says Dr. Field, who also co-directs AdventHealth’s Gamma Knife program.
That said, Gamma Knife does not remove the tumor, which means that existing symptoms like vertigo may remain. For people who want relief from these problems — or who can’t tolerate living with the tumor — surgery offers an alternative.
There are three surgical approaches, Dr. Field says, each with their own advantages and disadvantages:
- Middle Cranial Fossa: This approach involves the removal of a small piece of bone in front of the ear. It offers the best chance of preserving hearing but is usually only used for small tumors.
- Retro-Sigmoid Craniotomy: This minimally invasive procedure uses a small hole — between the size of a dime and a quarter — to give the surgical team access to the tumor. In many cases, patients lose hearing in one ear.
- Translabyrinthine Craniotomy: This surgery involves the removal of most of a patient’s ear bone to reach the tumor. It may offer the surgeon a better chance of seeing and removing the tumor, but at the cost of total hearing loss in one ear.
In general, about 70% of Dr. Field’s patients choose Gamma Knife and 30% choose surgery.
Team Approach Is Best
No matter which approach they pick, patients benefit from a team of experts, including a neurotologist, or expert in the inner ear.
“We do this surgery as a team because when the neurotologist and neurosurgeon work together, outcomes are better,” Dr. Field says.
Each week, the AdventHealth Neuroscience Institute team holds a brain tumor conference where they discuss each patient’s medical history, images of the tumor and goals for treatment. The team collectively identifies the best options for their unique case.
“To me, it’s rewarding to know we can offer the best options for a cure,” Dr. Field says.
Acoustic neuroma is rare, affecting about 1 in 100,000 people, but it’s not rare to Dr. Field and his colleagues. The fact that they’ve seen so many people with acoustic neuroma and other unusual brain diseases provides a tremendous advantage to their patients.
The expertise of Dr. Field and his team, combined with the latest technology, makes AdventHealth Neuroscience Institute the first choice for patients with acoustic neuroma or other brain conditions. We also offer whole-person care that tends to your mind and spirit along with your body.
To learn more about the care we offer, visit the AdventHealth Neuroscience Institute's website or call Call407-303-7944.