Nguyen Ngoc began experiencing unusual symptoms six months ago, particularly when bending over or turning. These recently intensified, with persistent vomiting, unsteady gait, and decreased hearing, prompting him to seek medical attention at Tam Anh General Hospital in Ho Chi Minh City. CT and 3 Tesla MRI scans revealed a nearly 5 cm mass, about the size of a lemon, in the right posterior fossa, compressing the cerebellum and extending close to the brainstem.

On 26/6, Dr. Chu Tan Si, Head of Neurosurgery at Tam Anh General Hospital's Center for Neuroscience, identified the mass as an acoustic neuroma, also known as a vestibular schwannoma. This type of tumor typically develops silently. Early symptoms, such as unilateral tinnitus, slight hearing loss, and mild imbalance, often go unnoticed.

Ngoc's tumor originated in the inner ear canal and spread to the cerebellopontine angle, a critical area containing cranial nerves, including the 7th (facial) and 8th (vestibulocochlear) nerves. As the tumor grew, it caused hearing loss, loss of balance, facial distortion, speech difficulties, and swallowing problems.

Dr. Tan Si consults with Nguyen Ngoc. Photo: Tam Anh General Hospital

Dr. Tan Si consults with Nguyen Ngoc. Photo: Tam Anh General Hospital

Following consultation, doctors decided to surgically remove the tumor through a retrosigmoid approach (behind the ear). During the nearly three-hour procedure, aided by AI Kinevo 900 microscopes, intraoperative neurophysiological monitoring, and ultrasonic tissue dissection equipment, the surgical team meticulously dissected approximately 90% of the tumor, leaving a small portion attached to the brainstem to minimize the risk of complications.

Ngoc is undergoing regular MRI monitoring to assess the remaining tumor. If it grows or causes compression, doctors will consider Gamma Knife radiosurgery, a non-invasive treatment using highly focused radiation to control tumor growth without traditional surgery.

Doctors remove Ngoc's brain tumor with the assistance of the AI Kinevo 900 microscope. Photo: Tam Anh General Hospital

Doctors remove Ngoc's brain tumor with the assistance of the AI Kinevo 900 microscope. Photo: Tam Anh General Hospital

Post-operatively, Ngoc is alert, eating, hearing clearly, and has symmetrical facial movements. He can walk around his room. Post-operative imaging shows good tumor control, with no signs of cerebral edema or fluid accumulation. He has been discharged and will continue regular monitoring and rehabilitation at home.

Pathology confirmed the tumor as a schwannoma, a benign tumor arising from the nerve sheath. Dr. Si noted that the symptoms of this tumor are easily mistaken for vertigo, otitis media, or nervous system disorders. This often leads patients to self-medicate, delaying diagnosis and allowing the tumor to progress undetected.

Early symptoms are often subtle, including tinnitus, slight hearing loss, and unsteadiness. As the tumor grows, patients may experience nausea, loss of balance, facial paralysis, speech and hearing difficulties, and difficulty swallowing due to cranial nerve compression. The tumor can become life-threatening if it compresses the brainstem. Dr. Si recommends consulting a neurologist if you experience persistent unilateral tinnitus, hearing loss, loss of balance, unexplained dizziness, or recurring nausea and vomiting. These could be early signs of a brain tumor or other posterior fossa conditions. MRI and CT scans can enable early detection, timely treatment, and limit severe complications.

Phuong Thy