SOMETIMES HEARING LOSS IS NOT JUST A MATTER OF AGE, BUT A SIGNAL OF A MUCH MORE SERIOUS PROBLEM

A 72-year-old patient from the Krasnodar region had been seeing otorhinolaryngologist specialist for many years due to gradually worsening hearing. Treatments were adjusted and causes investigated, but only the MRI results provided an answer: a tumor of the auditory nerve, deeply located and already beginning to compress the brainstem – the area responsible for breathing, swallowing, movement and heart function.

At the P. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, doctors decided on a microsurgical operation — one of the most risky procedures in neurosurgery. The tumor was located just millimeters away from vital structures, with the facial nerve nearby, damage to which could permanently alter the patient’s appearance and quality of life. Doctors clarify that it was an acoustic neuroma — a benign tumor that is dangerous precisely because of its location. «It grows from the auditory nerve and compresses the brainstem. There are centers responsible for breathing, heartbeat, swallowing — all nearby, literally millimeters apart», – explains the patient’s neurosurgeon, Nikita Mikhailov. By the time she sought treatment, the patient’s hearing was partially preserved, but the first «neurological hints» appeared: due to pressure on the trigeminal nerve, numbness and shooting pain occurred on one side of the face.

During the operation, the team worked in the cerebellopontine angle — access is achieved through a small trepanation behind the ear. The main challenge is the facial nerve: it can be «thinned» by the tumor to the finest «film» and is visually almost indistinguishable.
«We use neurophysiological monitoring; it helps identify the nerve during surgery and greatly reduces the risk of damage», -notes Anton Zaytsev, head of the Neurosurgery Department. «In this case, we managed not only to locate the nerve but also to preserve its function: the patient can walk, take care of herself, there is no pronounced dizziness, and facial sensitivity is gradually restoring».
The next step is the second and, as doctors hope, final stage of treatment: after reducing the tumor, the patient will be referred for radiosurgery (CyberKnife/Gamma Knife) for final control of the remaining tissue. According to Nikita Mikhailov, with this combined approach, the likelihood of tumor-free growth over five years reaches 95%.