USC’s Acoustic Neuroma Center leads the way in personalized care

The most common symptom of an acoustic neuroma (AN) is diminished hearing in one ear, and while an AN diagnosis may feel overwhelming at first, these tumors are benign and slow-growing, giving patients time to carefully consider their options.

Although non-cancerous, ANs’ location in the tight space near critical nerves means that they can affect hearing, balance, and facial movement, which is why surgical and radiotherapy interventions may sometimes be recommended. As Janet Choi, MD from the USC Caruso Department of Otolaryngology – Head and Neck Surgery (OHNS) emphasizes: “The goal is not only to treat the tumor but also to understand each patient’s priorities and values and incorporate them into a personalized treatment plan.”

USC’s Acoustic Neuroma Center is uniquely equipped to provide patients with such personalized treatment plans given its multidisciplinary, team-based approach. Seiji Shibata, MD, PhD, appreciates that this allows for care “to be tailored to tumor size and growth, patient age and health, and hearing status rather than a one-size-fits-all model.” There is a strong emphasis on hearing preservation, balance care, and rehabilitation, not just tumor treatment, and patients have access to all major treatment options, such as careful observation with serial imaging, focused radiation therapy to stop tumor growth, and microsurgical removal of the tumor.

“With this device, we’ve found that patients with ANs have an inner ear fluid imbalance and that this may be the reason for some of their hearing loss. We hope that this new technology will allow us to perform surgery in such a way to better preserve, or perhaps even restore, hearing in select patients.”

John Oghalai, MD
Chair, USC Caruso Department of Otolaryngology-Head and Neck Surgery

When surgery is necessary, USC’s team reduces the risk of hearing loss by using surgical techniques designed to preserve hearing and employing real-time auditory nerve monitoring by highly experienced specialists. In cases where hearing preservation is not possible, surgeons at USC can provide simultaneous or staged placement of a cochlear implant or brainstem implant to restore hearing.

Conversely, the use of radiotherapy may be a more appropriate treatment option in some cases. Eric Chang, MD, has pioneered the use of Gamma Knife Esprit radiation for ANs, which improves on previous Gamma Knife radiation therapy by enhancing patient comfort with a frameless mask, incorporating extremely precise built-in on-board cone-beam CT imaging, and allowing for fractionated treatment (i.e. when the total dose of radiation is divided into multiple smaller doses administered over several days or weeks), which can reduce negative side effects.

Finally, USC OHNS is engaged in several ongoing research projects as they continue to strive to optimize patient outcomes. For example, John Oghalai, MD, is thrilled to be part of an NIH-funded project that involves high resolution imaging of the inner ear during surgery: “With this device, we’ve found that patients with ANs have an inner ear fluid imbalance and that this may be the reason for some of their hearing loss. We hope that this new technology will allow us to perform surgery in such a way to better preserve, or perhaps even restore, hearing in select patients.”

In addition, USC clinicians have worked closely with researchers in the lab of Ksenia Gnedeva, PhD, to develop a novel molecular treatment that could potentially lead to a gene therapy with long-lasting benefits and fewer side effects than current treatments.

“Through collaborative efforts in tumor biology, nerve regeneration, and advanced auditory technologies,” Choi explains, “our goal is to translate laboratory discoveries into safer therapies, better hearing outcomes, and improved long-term quality of life for patients.”