Acoustic neuromas are benign tumors that originate from the nerves that serve hearing and balance. These benign tumors can often present with hearing loss, ringing in the ear, and occasionally they can present with more serious symptoms such as hydrocephalus, which is an impairment in the circulation of the flow of fluid in the brain. Dr. Ghosh had the privilege of doing specialized training in the surgical management of acoustic neuromas with Dr. William Hitselberger. Dr. Hitselberger is a pioneering neurosurgeon who has the greatest experience in the operative management of acoustic neuromas in the history of man with over 6,000 acoustic neuromas performed by him during his tenure at the House Ear Clinic. Dr. Ghosh had the privilege on scrubbing on over 100 cases with both Dr. Hitselberger and Dr. John Diaz Day during his time at the House Ear Clinic. Dr. Ghosh brought that experience to the skull base team of Senta Clinic in San Diego.The current tools in the management of acoustic neuroma include microsurgical resection, stereotactic radiosurgery with CyberKnife or Gamma Knife, and simple observation as a certain percentage of acoustic neuromas do not grow in a patient’s lifetime. Dr. Ghosh has considerable expertise and experience in every facet of the management of acoustic neuroma. He is trained and experienced in the three different types of surgical approaches to acoustic neuromas including the retrosigmoid craniotomy, the translabyrinthine craniotomy, and the middle fossa craniotomy. He is one of the few neurosurgeons in the country that has experience and training in all three approaches and he can tailor the surgical approach to the individual patient’s need.
In addition, Dr. Ghosh is trained in the two key modalities of radiosurgery for acoustic neuroma including Gamma Knife radiosurgery and CyberKnife radiosurgery and he is able to utilize both of these techniques when it is in the best interest of the patient. A recent trend in the management of acoustic neuromas includes the planned subtotal resection of giant acoustic neuromas, which is done in the interest of decompression of the critical brainstem and neurovascular structures while focusing on avoidance of injury to the facial nerve. In this situation, the tumor is substantially debulked and then the remaining tumor is treated with radiosurgery in a planned manner sometime after the primary surgery. This combined technique has been used with great success with several patients in the past as can be seen in the video of Dr. Greaves. Dr. Ghosh is one of a small handful of neurosurgeons in the country who can provide a full armamentarium of treatment options for patients with acoustic neuromas.