Acoustic Neuroma

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(Neurilemoma; Vestibular Schwannoma; Acoustic Schwannoma)

Definition

An acoustic neuroma is a tumor that grows on the nerve leading from the brainstem to the ear. This nerve plays a role in hearing and in maintaining your balance. An acoustic neuroma grows relatively slowly. It is a benign tumor which means it is not cancerous. However, this condition can still cause serious problems.
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Causes

The exact cause of an acoustic neuroma is unknown.

Risk Factors

Factors that may increase your chance of an acoustic neuroma include:
  • Age: 30-60 (average age of diagnosis is 50)
  • History of the disease neurofibromatosis type 2 (NF2)
  • Family history of NF2

Symptoms

The first symptoms of an acoustic neuroma include:
  • Gradual hearing loss in one ear with near normal hearing in the other ear
  • Decrease in sound discrimination, especially when talking on the telephone
  • Ringing in the affected ear, called tinnitus
As the neuroma gradually grows larger, symptoms may include:
  • Balance problems
  • Facial numbness and tingling
  • Weakness of the facial muscles on the side of the tumor
If headaches or mental confusion occurs, the tumor may be life threatening. Call your doctor right away.

Diagnosis

The doctor will ask about your symptoms and medical history. Your ears will be examined. Your doctor will also do tests for your nervous system. Tests may include:
  • Audiogram—a test that measures hearing in both ears
  • Auditory brainstem response test—a test that measures the rate of electric impulses traveling from the inner ear to the brainstem, almost always abnormal in the presence of an acoustic neuroma
  • Electronystagmography—Cold and warm water or air is inserted in the ear canal, and the resulting dizziness and rapid eye movement are recorded.
  • MRI scan—a test that uses magnetic waves to make pictures of the inside of the head
  • CT scan—a type of x-ray that uses a computer to make pictures of the inside of the head

Treatment

Treatment depends on your age, general health, the size and location of the tumor, and its rate of growth. Treatment may include:

Observation

If the tumor is very small, your doctor may just monitor its growth. This is common among people over age 70.

Microsurgical Removal

As the tumor grows and/or hearing becomes impaired, removal of the tumor may be necessary. The type of surgery depends on the size and location of the tumor. Complications of surgery may include permanent hearing loss and/or paralysis of facial muscles on the affected side.

Radiation Therapy

Radiation therapy is the use of radiation to kill cells and shrink tumors. Radiation is expected to prevent further growth of the tumor. Radiation may be used when tumors are small and surgery is not possible. This method may preserve hearing. It may be given over several treatments or one large dose. You may be treated with a procedure called stereotactic radiosurgery. This surgery uses a beam of radiation to destroy the tumor tissue.

Prevention

There are no guidelines for preventing acoustic neuroma because the cause is not usually known.

RESOURCES

Acoustic Neuroma Association http://www.anausa.org

American Academy of Audiology http://www.audiology.org

CANADIAN RESOURCES

Canadian Academy of Audiology http://www.canadianaudiology.ca

The College of Family Physicians of Canada http://www.cfpc.ca

References

Acoustic Neuroma. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 18, 2012. Accessed August 30, 2012.

American Hearing Research Foundation. Available at: http://american-hearing.org/disorders/acoustic-neuroma. Accessed August 30, 2012.

Vestibular Disorders Association. Available at: http://vestibular.org/acoustic-neuroma. Accessed August 30, 2012.

Merritt H, Rowland L. Merritt’s Neurology. Philadelphia, PA: Lippincott Williams and Wilkins; 2000.

What is acoustic neuroma? Acoustic Neuroma Association website. Available at: http://www.anausa.org/index.php/overview/what-is-acoustic-neuroma. Accessed July 9, 2009.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 10/2012 -
  • Update Date: 10/11/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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