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Acoustic Neuroma

Last reviewed by Dr. Raj MD on January 12th, 2022.

What is Acoustic Neuroma?

This is a benign, or non-cancerous, tumor that grows in the cells of the main nerve that connects your inner ear to your brain. This nerve is called the vestibular cochlear nerve. This cannel can be found at the back of your ear just under your brain. This medical condition is also referred to as Auditory Tumor Condition or Vestibular Schwannoma. It is a slow growing tumor and as it grows it will start to put pressure on the balancing and audio system of your brain. This type of tumor will not spread to other parts of your body but it can damage some important nerves as it gets bigger. Approximately one in out of fifty thousand people will have acoustic neuroma according to the Acoustic Neuroma Association. The elderly are at a higher risk of developing this medical condition. Acoustic neuroma is not common.

Symptoms

In many of the cases of acoustic neuroma at the beginning the symptoms may not appear at all or else they are so mild that they are overlooked. As the condition worsens, or the tumor begins to grow and starts to press on your nearby blood vessels, brain structures, or adjacent nerves, a person may notice some of the following symptoms:

Hearing loss

This is usually the first sign that people notice when they have acoustic neuroma. Because of the hearing loss you are not able to understand properly speech words, especially when you are using the telephone. When you experience this symptom it will usually affect only one side of your ear but not both ears.

Tinnitus

This is better known as ringing of the ears and is often described as hearing different sounds like hissing or ringing inside their head even though there is no actual sound. It can come and go or it can happen constantly. The volume can vary from subtle to intense.

Loss of balance

This is also another early sign and in the beginning this symptom may just appear occasionally but as the tumor gets bigger it can happen more often. When a person looses their balance they will normally fall down on the side that is affected. Some even complain of experiencing vertigo also.

Headache

From research that has been conducted it has been found that headaches and acoustic neuroma are related. When the tumor is putting pressure on the inside of your skull you will feel a sense of heaviness in your head. It may even extend up to your neck. Normally the headache is felt in one side of your head with it being especially bad in the morning and night. It may also be aggravated when you lie down, coughing, sneezing, standing up, etc.

Other Symptoms

  • Weakness, pain, or numbness in your face or one ear. You may also have twitches in your face.
  • Problems with your visionโ€”in some cases there is a link between problems with your vision and acoustic neuroma.
  • Fatigue

In some rare instances the tumor can get large enough to compress your brainstem and if this happens, it can be life-threatening.

Causes

The exact cause of acoustic neuroma is not known but research states that it could be a malfunctioning gene on your Chromosome 22 that helps to prevent the formation of tumors in the body. This particular chromosome produces a protein that helps control your growth of Schwann cells, which is a neurological cell that wraps around your nerve fiber in your peripheral nervous system that covers your nerves. Scientists are not sure what causes this gene to malfunction. It has been linked with a genetic disorder called neurofibromatosis Type 2 (NF2).

Treatment

What treatment is done would depend on the location and size of the tumor, your overall health, and your age. If the tumor is not treated it can damage your nerves for balance and hearing, and maybe even the nerves responsible for feeling in your face and movement. In addition, if no treatment is done fluid can build up in your brain and cause a life-threatening condition called hydrocephalus. One option for managing acoustic neuroma would be:

Monitoring

If the acoustic neuroma is growing slowly or not at all and you have no symptoms or very few symptoms your physician may just want to monitor it. This is especially true if you are not a good candidate for treatment or an older adult. Your physician may recommend regular hearing and imaging tests, such as an MRI, every six to twelve months to check on the progress of the tumor. If any of these tests show that the tumor is growing or it is causing hearing loss that is progressive or other problems you may need to undergo some type of treatment.

Surgery

The other two ways to treat acoustic neuroma is through surgery to remove the tumor completely or by stereotactic radiosurgery, which is not a surgical procedure. Doing surgery to remove the tumor completely would also help to prevent facial paralysis by preserving the facial nerve, and try to preserve your hearing as much as they can. The reason that a surgeon may opt to remove an acoustic neuroma could include tumors that are:

  • Large
  • Causing symptoms
  • Pressing on the brain
  • Growing quickly

The surgery would be done not only to remove the tumor but also to help prevent damage to other nerves. As with any type of surgery, there can be risks and complications such as:

  • Having a complete loss of hearing
  • Having facial muscles that are weakened
  • Having ringing in your ears
  • Having the incision leak cerebrospinal fluid
  • Having problems with your balance
  • Having headaches that are persistent

The surgery to remove the tumor completely is done under general anesthesia and the surgeon will remove the tumor either through an incision in your skull or through your inner ear. You will be in the hospital four to six days but can take six weeks or more to recover completely.

If your surgeon does stereotatic radiosurgery they will send radiation directly to your tumor without making any type of incision. The reason that this surgery would be chosen is to stop or slow down the growth of the tumor but is only done if you are not a candidate for the surgery to remove it completely or it is a small acoustic neuroma. It can take from weeks to years before the effects of this type of surgery become noticeable. After having this type of surgery your physician will monitor how well you are progressing with hearing tests and imaging scans.

There are risks with stereotactic radiosurgery and they can include:

  • Facial weakness
  • Problems with your balance
  • Hearing loss
  • Damaging nerves.

Prognosis

Because acoustic neuroma are not cancerous the prognosis is good for recovering after having the tumor removed but the biggest problems is once you have hearing loss you will not get that back even with radiosurgery or surgery to remove the tumor. This is why it is imperative that once you notice any of the symptoms that you see your physician as soon as possible for treatment and too find out how big the tumor is. The sooner the tumor is treated the better the chance for a complete recovery and less of a chance for total hearing loss.

Acoustic Neuroma Pictures

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