Otoneurosurgery Unit

The Otoneurosurgery Unit treats patients with tumours of the pontocerebellar angle and complex inner ear lesions that require a highly specialised surgical approach due to their proximity to vital neurological structures.

It intervenes when the location of the lesion may compromise hearing, balance or facial nerve function, and expert planning is required to combine tumour control with functional preservation.

Assessment of pontocerebellar angle lesions

The unit is aimed at people with acoustic neuroma (vestibular schwannoma), meningiomas of the internal auditory canal, squamous cell carcinomas and lesions associated with neurofibromatosis type 2, amongst other conditions.

The assessment is particularly indicated following a radiological diagnosis of a lesion at the cerebellopontine angle or when a decision must be made between monitoring, radiotherapy or surgery.

The initial aim is to analyse the tumour’s size, its relationship with adjacent nerves and blood vessels, and the patient’s previous functional status, in order to determine the most appropriate treatment strategy.

Diagnostic assessment and joint planning

The process begins with a detailed clinical assessment, a comprehensive audiological evaluation and a high-resolution MRI scan.

Each case is analysed individually and planned in collaboration with the Neurosurgery Department, selecting the safest approach and setting realistic objectives in terms of preserving hearing and facial function.

Function-preserving surgery

Surgical treatment is planned to balance tumour resection with the protection of essential neurological structures.

The strategy is tailored to the size and location of the tumour, prioritising, wherever possible, the preservation of hearing and the integrity of the facial nerve. Intraoperative decisions are made with the aim of ensuring maximum neurological safety.

Structured neurological follow-up

Following surgery, a follow-up plan is established, comprising clinical monitoring, regular imaging scans and audiological assessment.

In cases of lesions associated with genetic disorders or with an unpredictable course, long-term monitoring is particularly important for maintaining clinical stability.

Clear information and support in decision-making

Otoneurosurgery involves complex decisions that require a clear and calm understanding. From the very first consultation, we take the time needed to explain the diagnosis, the treatment options and the potential risks relating to hearing, balance and facial function.

Decision-making is a shared process, particularly when there are different options to consider, such as observation, radiotherapy or surgery. Each patient receives clear information about the treatment objectives and realistic functional expectations.

Support is provided throughout the entire process, including post-operative follow-up and coordination with the Neurosurgery Department and other specialities. The unit combines advanced microsurgical expertise with a person-centred clinical approach, providing clear information and the time needed to make an informed and confident decision.