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Understanding Acoustic Neuroma

Hearing Loss24 January 2024Updated 6 March 20243 minutes read
The Short Answer

An acoustic neuroma (vestibular schwannoma) is a benign, non-cancerous growth on the nerve that carries hearing and balance signals to the brain. It usually grows slowly over many years and does not spread. Typical early signs include gradual hearing loss in one ear, tinnitus and unsteadiness, most often affecting adults aged 30 to 60.

At a Glance

Key Takeaways

  • An acoustic neuroma is a benign, non-cancerous tumour on the vestibulocochlear (hearing and balance) nerve.
  • The cause is not well understood; most cases arise spontaneously, though NF2 can raise the risk.
  • Common signs include one-sided hearing loss, tinnitus, balance problems, vertigo and facial numbness.
  • Diagnosis combines hearing tests and MRI; options are monitoring, radiation therapy or surgery.

Acoustic neuroma, also known as vestibular schwannoma, is a relatively rare but potentially serious medical condition that affects the vestibulocochlear nerve. This nerve plays a crucial role in both hearing and balance, and the emergence of an acoustic neuroma can give rise to various symptoms and complications.

What is Acoustic Neuroma?

An acoustic neuroma is a benign, non-cancerous tumour that forms on the vestibulocochlear nerve, commonly found within the inner ear canal. Although these tumours are not cancerous, their expansion can lead to considerable complications as they compress neighbouring structures and disrupt the normal functioning of the nerve.

Causes of Acoustic Neuroma

The cause of acoustic neuromas is not well understood. Nevertheless, it is widely believed that the majority of cases arise spontaneously, devoid of any discernible genetic or environmental influences that contribute to their formation. In exceptional cases, certain genetic disorders, such as neurofibromatosis type II (NF2), may elevate the susceptibility to developing acoustic neuromas.

Common Symptoms

The symptoms of acoustic neuroma can vary widely from person to person and depend on the size and location of the tumour. Some common signs and symptoms include:

Hearing Loss: One of the initial signs is a progressive or abrupt hearing loss in one ear, which might initially be misinterpreted as age-related hearing loss.

Tinnitus: Patients frequently describe experiencing a continuous ringing or buzzing sensation in the affected ear.

Balance Problems: Acoustic neuromas may lead to a lack of balance, instability, and challenges in coordinating movements and walking.

Vertigo: Frequent episodes of vertigo (dizziness) may manifest, normally accompanied by feelings of nausea and vomiting.

Facial Numbness or Weakness: In some cases, the growth of the tumour may exert pressure on the facial nerve, resulting in facial numbness or muscle weakness on a single side of the face.

Pressure Sensations: Patients on the affected side may encounter a sensation of ear fullness or pressure.

Headaches: Persistent headaches, especially in the back of the head, may be linked to larger tumours.

Diagnosis of Acoustic Neuroma

Diagnosing acoustic neuroma usually involves several steps:

Medical History and Physical Examination: A healthcare professional will collect data regarding your symptoms, medical background, and conduct a thorough physical assessment, with a specific emphasis on the ear and neurological function.

Audiological Testing: Hearing assessments, such as audiometry and brainstem auditory evoked response (BAER) tests, aid in evaluating hearing loss and determining its underlying cause.

Imaging Studies: An acoustic neuroma can be visualised and confirmed using an MRI, which is the primary imaging method utilised for this purpose. This technique provides detailed images that accurately depict the size and location of the tumour.

Monitoring and Follow-up: In certain instances, periodic imaging can be employed to closely monitor the growth of small tumours and determine the most suitable course of action.

Different treatment options for acoustic neuroma may consist of monitoring the condition, utilising radiation therapy, or opting for surgical intervention. The choice of treatment is determined by factors such as the size and location of the tumour, as well as the patient’s overall health.

Acoustic neuroma is an uncommon ailment that can impact one’s hearing and balance, resulting in a variety of symptoms. Timely identification and diagnosis play a vital role in determining the suitable treatment and averting potential complications. If you or someone you are acquainted with any of the symptoms mentioned above, it is advisable to seek the assistance of a healthcare expert for a full evaluation and expert advice on the most suitable course of action.

Patient Questions

Frequently Asked Questions

What is an acoustic neuroma?

An acoustic neuroma, also called a vestibular schwannoma, is a benign (non-cancerous) tumour that grows on the vestibulocochlear nerve near the inner ear. Although it is not cancerous, it can press on nearby structures as it grows. It usually develops slowly over many years.

What are the symptoms of an acoustic neuroma?

The most common early sign is gradual hearing loss in one ear, often with tinnitus (ringing or buzzing). Balance problems, vertigo, a feeling of fullness in the ear and, with larger tumours, facial numbness or weakness and headaches can also occur. Symptoms vary with the tumour's size and position.

What causes an acoustic neuroma?

In most cases the cause is not well understood, and the tumour appears spontaneously with no clear genetic or environmental trigger. A small number of cases are linked to an inherited condition called neurofibromatosis type 2 (NF2), which raises the risk of these tumours.

How is an acoustic neuroma diagnosed?

Diagnosis usually starts with a review of your symptoms and medical history, followed by hearing tests such as audiometry. An MRI scan is the main imaging test used to confirm the tumour and show its size and location. Small tumours may be watched with repeat scans.

How is an acoustic neuroma treated?

Treatment depends on the tumour's size and location and on your general health. Options include monitoring small, slow-growing tumours with regular scans, radiotherapy such as stereotactic radiosurgery, or surgery to remove the tumour. Timely diagnosis helps guide the most suitable approach.

References

Sources

  1. NHSAcoustic neuroma (vestibular schwannoma)
  2. NHSNeurofibromatosis type 2 (NF2-related schwannomatosis)
  3. Acta Neurochirurgica (PMC / NIH)Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study
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