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Acoustic Neuroma

What Is an Acoustic Neuroma?

An acoustic neuroma (also called vestibular schwannoma) is a noncancerous and usually slow-growing tumor that forms on the vestibular nerve, one of the nerves that connects your inner ear to your brain. The vestibular nerve controls your balance, so a tumor pressing on this nerve can cause unsteadiness, hearing loss and ringing in the ears.

An acoustic neuroma develops when the cells that wrap around the fibers of the vestibular nerve, called Schwann cells, overproduce. The exact cause of this condition is unknown, and no risk factors have been identified.

Symptoms

Symptoms of acoustic neuroma are usually mild at first but worsen as the tumor grows. Symptoms include: 

  • Dizziness — Feelings of unbalance, floating or spinning can lead to falls or injuries.
  • Loss of hearing in one ear — Usually loss of hearing in the affected ear is slow, occurring over many years. About 25 percent of people with acoustic neuroma will experience sudden hearing loss. 
  • Loss of feeling — The acoustic neuroma pressure on other nerves can lead to numbness or tingling on the face.
  • Facial Immobility — Pressure from the acoustic neuroma on the nerve that makes the face move can affect its ability to coordinate face movements, leading to uneven smiling, difficulties with eye closure, changes in speech, and difficulties keeping food in the mouth while swallowing.
  • Tinnitus — As hearing fades, some people hear a ringing, buzzing or hissing sound in the ears, known as tinnitus.
  • Headache — As acoustic neuromas become very large, they can block the normal flow of brain fluid, leading to headaches.
  • Difficulty with movement (Ataxia) — Large acoustic neuromas can affect the ability to walk normally due to pressure on the brain.

Treatment Options

Because the symptoms of having an acoustic neuroma are similar to those present with middle ear issues, diagnosis can be difficult. Diagnosis is made through ear exams, hearing tests, and imaging scans, such as computerized tomography (CT) and magnetic resonance imaging (MRI).

The three most common management options are:

  • Monitoring — This option is usually for elderly or infirm patients, or for tumors that are small, cause no or few symptoms, aren’t growing or are growing very slowly. However, since these tumors continue to grow over time, most younger patients with even small tumors will require treatment at some time.
  • Radiation — Also known as stereotactic radiosurgery, this option is used for tumors less than 2.5 centimeters in diameter and for elderly patients who can’t tolerate surgery.
  • Surgery — Surgery removes tumors through the inner ear or an opening in the skull. It is usually performed under general anesthesia.

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