Acoustic Neuroma Explained

By: Adrian Cruce

Benign acoustic neuromas are slow-growing tumors that do not spread. Small tumors may be monitored with regular MRI scans if symptoms are not being experienced.

Large acoustic neuromas can lead to hearing loss in one ear, ringing in the ears (tinnitus), dizziness and balance issues as well as dizziness and dizziness during treatment options such as observation, surgery or radiation therapy.

Symptoms

At first, an acoustic neuroma is usually identified by gradual loss of hearing in one ear, often with accompanying symptoms like ringing in the ears (tinnitus) and feelings of fullness in that ear. Dizziness and issues maintaining balance may also arise as this tumor interferes with Schwann cells that relay auditory signals from your inner ear into your brain – when pressure is applied these cells release random electrical impulses which your brain interprets as sound creating tinnitus which sounds like ringing, buzzing, whining or low roaring sounds within your own ears without external sources causing this phenomenon tinnitus is an internal source originating from within and creates its own noise source causing dizziness or problems maintaining balance issues as a result.

As an acoustic neuroma grows, it can compress key structures of the brain responsible for balance, movement and facial nerve functionality. Furthermore, larger tumors may cause hydrocephalus – an extremely dangerous condition where excess fluid builds up inside of skull.

Other symptoms may include headache, neck pain and weakness in facial muscles. These could be the result of the acoustic neuroma pushing against the dura of your brain and pushing against the fifth cranial nerve that transmits sensation from your face to your brain – this may lead to pins-and-needles sensations in the head or neck as well as numbness or tingling sensations on top or front side of head.

As part of your health care team, it is important to discuss symptoms with both an ear, nose and throat specialist as well as a neurosurgeon. You should also be open about sharing emotions with family and friends; support groups may be useful as well; both physical and virtual groups exist for those living with an acoustic neuroma.

Diagnosis

Audiometry, or hearing testing, is the first step toward diagnosing an acoustic neuroma. During this test, sound waves are played into one ear and you indicate when you hear them; then repeated with lower tones until softest level you still detect is found – giving your provider insight into both how much hearing loss you have as well as which ear may be affected. An audiologist should administer this test.

Magnetic Resonance Imaging (MRI) scans may also be performed. An MRI is an imaging test that takes images of your inner ear and brain using large magnets and radio waves, and can provide images that detect small acoustic neuromas. Sometimes dye injection is used to highlight it more effectively; depending on which tissue types exist in an acoustic neuroma can help determine its severity; Antoni B tissue typically occurs in larger tumors with disorganized cell arrangements while other possible types include necrosis, old hemorrhages blood vessels or cystic changes.

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Your GP will assess whether an acoustic neuroma could be the source of your symptoms. If this is confirmed, they may refer you to either an ENT specialist or neurosurgeon to further explore potential solutions.

While most acoustic neuromas are caused by random genetic inheritance, they have also been linked to neurofibromatosis type 2. Acoustic neuromas are most likely found on the left side of the head although they can also appear on its opposite side.

Treatment options for an acoustic neuroma depend on its size and location, your age and health status. Small acoustic neuromas without symptoms may not require medical intervention; regular MRI scans could suffice. Larger tumors that grow quickly should be addressed surgically or via radiation therapy to protect hearing and avoid other nerve damage. It is essential that medical centers that specialize in treating this condition include experienced multidisciplinary teams such as neurosurgeons, otologic surgeons, hearing rehabilitation specialists or radiation oncologists among others.

Treatment

UF Health offers an array of treatments for acoustic neuromas. Your ear, nose and throat team will identify which option is most appropriate based on a comprehensive review of symptoms, physical exam and imaging tests. Options available to you may include observation, surgery and radiation – with observation being advised for small tumors growing slowly as it involves regularly scheduled MRI scans and hearing tests without intervening until there is any sign of rapid expansion or other symptoms are apparent.

Large tumors should usually not be left to grow unchecked, as their rapid expansion can damage hearing and balance nerves as well as brain structures, leading to facial paralysis or even numbness in part of your face. Acoustic neuromas can also cause hydrocephalus which could become life threatening if left untreated.

Surgery to treat an acoustic neuroma can be performed either through microsurgery or stereotactic radiosurgery, with stereotactic radiation therapy serving as an noninvasive solution to reduce or stop its growth. Stereotactic radiation involves targeting focused gamma radiation towards the area in question and using targeted doses of radiation directly against it – this approach may result in lessened growth over time.

At Mayo Clinic, experts in otolaryngology (ear, nose and throat) and neurosurgery have performed thousands of acoustic neuromas surgeries with minimal side effects such as hearing loss in one ear or vestibular schwannomas.

An acoustic neuroma is caused by an abnormal overproduction of Schwann cells that wrap and support nerve fibers in the inner ear, typically occurring between middle age and late life and more often affecting women than men. The condition typically manifests on either side of the head and more commonly affects individuals who carry the genetic condition neurofibromatosis type 2, typically impacting women more.

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Molecularly speaking, bilateral vestibular schwannomas result from mutations on chromosome 22 that alter one or more genes. Though its cause remains unknown, those carrying this mutation are at greater risk of bilateral vestibular schwannomas forming on hearing and balance nerves on both sides of their heads – these neuromas are commonly referred to as bilateral vestibular schwannomas. Even if diagnosed with one of these rare conditions, educating yourself about it can help make decisions that are best suited to you – from medical literature or others suffering similar conditions as well as speaking with your otologist or neurosurgeon about how best manage them.

Prognosis

An acoustic neuroma is a slow-growing tumor that is typically benign (noncancerous). While most acoustic neuromas do not spread to other areas of the brain, their growth can put pressure on important structures, including your eighth cranial nerve which links your inner ear with your brain for hearing and balance information transmission. A large acoustic neuroma may result in symptoms like dizziness and hearing loss in one ear as well as ringing in one or both ears (tinnitus).

Most often, doctors can treat an acoustic neuroma with surgery and radiation therapy; the exact method will depend on factors like your age, general health status, and size of the tumor.

Most acoustic neuromas occur spontaneously, meaning they develop without apparent reason. However, they can also result from gene mutation (alterations to your DNA structure). One common genetic cause for an acoustic neuroma is loss of segments from chromosome 22.

An acoustic neuroma’s symptoms tend to start off mild but become increasingly severe over time, including hearing loss in one ear and ringing in your ears (tinnitus). When large enough, however, an acoustic neuroma can compress critical brain structures – including cerebrospinal fluid which connects your brain with your spinal cord – leading to headaches or weakness in arms or legs that result.

Neurosurgeons can remove your acoustic neuroma by performing a craniotomy procedure; its type will depend on factors like its location and size.

Your healthcare team will closely monitor an acoustic neuroma with regular MRI scans. This is important as fewer symptoms improve prognosis for an acoustic neuroma.

Participating in rehabilitation therapy after treatment for an acoustic neuroma can help preserve quality of life after healing, including vestibular rehabilitation. This therapy serves to compensate for nerves that control balance being destroyed.