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Physicians team up to preserve hearing in people who have acoustic neuromas

Neurosurgeon Stephen Haines, M.D., and otolaryngologist Samuel Levine, M.D., work together on a procedure that requires expertise from both specialties. (Photo: Richard Anderson)

Is brain surgery a team sport? Two University of Minnesota faculty members are making a good case that it is.

They’re joining forces to treat acoustic neuromas—small tumors that grow on nerves that connect the inner ear with the brain—using new technology to preserve the patient’s hearing.

Acoustic neuromas typically are noncancerous and slow-growing tumors, according to the National Institutes of Health. But as the tumors do grow, they can press on nerves that affect hearing and balance.

They’re often removed through surgery, a technique that has improved in effectiveness with the advent of brain imaging techniques. Even so, the cochlear nerve, which is responsible for hearing, can easily be damaged in the surgery, especially for those who have larger tumors, resulting in deafness.

But Stephen Haines, M.D., head of the University of Minnesota Medical School’s Department of Neurosurgery, and Samuel Levine, M.D., a professor in the Departments of Otolaryngology and Neurosurgery, are working together to produce better outcomes for patients by using advanced imaging and monitoring techniques to keep patients’ hearing intact.

Surgery for acoustic neuromas requires the displacement of a bony canal, sometimes less than a centimeter long, running from the inner ear to the brainstem. During this procedure, imaging equipment helps Haines and Levine see as they perform the delicate work.

And as they remove the tumors, another technological tool offers assistance: equipment that monitors auditory brainstem response, the electrical signals neurons in the brain fire when detecting sound.

If the response remains in the normal range, the physicians know that the surgery has not affected hearing, Levine says. If necessary, they can adjust their approach to keep the cochlear nerve undamaged.

In this team procedure at University of Minnesota Medical Center, Fairview, Levine takes charge of accessing the tumors through the ear, and Haines handles their removal.

Levine compares their collaboration to the teamwork required by marriage, and Haines agrees.

“Working together like this is a matter of personal interaction and compromise, and we’ve learned a lot from each other,” Haines says. “This technique really requires the expertise of both specialties. It won’t work if you’re stubborn about only using the approaches you learned during your training.”

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