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Acoustic Neuroma

(Neurilemoma; Vestibular Schwannoma; Acoustic Schwannoma)

Pronounced: Ah-COO-stic New-ROH-mah

by Michelle Badash, MS

Definition

An acoustic neuroma is a tumor that grows on the nerve of the ear. This nerve runs from your brainstem to the ear and plays a role in hearing and in maintaining your balance. This is a benign tumor, which means it is not cancerous. However, this condition can still cause serious problems if the tumor is large enough to put pressure on your brainstem.

The Acoustic Nerve

Causes TOP

A tumor is caused by the abnormal growth of cells. This growth is determined by genes of the cells. An acoustic neuroma is caused by a problem with specific genes. It is not clear what causes the problem with the genes. Some environmental factors may play a role.

Risk Factors TOP

Acoustic neuroma is most common in people aged 30-60 years old. Factors that may increase your chance of acoustic neuroma include:

History of neurofibromatosis type 2 (NF2)—a condition that leads to growth of tumors on nerves
Family history of NF2
Long term exposure to loud sounds

Symptoms TOP

An acoustic neuroma grows slowly. Symptoms will be minor at first then worsen over time as the tumor grows. The first symptoms of an acoustic neuroma include:

Gradual hearing loss in one ear
Decrease in sound discrimination, especially when talking on the telephone
Ringing in the affected ear— tinnitus

As the neuroma 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 occur, the tumor may be life threatening. Call your doctor right away.

Diagnosis TOP

You will be asked about your symptoms and medical history. Your ears will be examined. Tests of your nervous system will also be done. There are a number of conditions that can affect your hearing including the very common ear infection. Acoustic neuroma may only be diagnosed after results from tests such as:

MRI scan of head
CT scan of head
Audiogram —hearing test
Auditory brainstem response test

Treatment TOP

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

Observation

Tumors may stay very small and cause few problems. In this case, the tumor may not need treatment. The doctor will monitor it for any changes. This is approach is common among people over age 70.

Microsurgical Removal

If the tumor is causing problems or is growing large it may need to be removed. 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 TOP

Radiation therapy is the use of radiation to kill cells and shrink tumors. It may also stop further growth of the tumor. Radiation may be used when tumors are small and surgery is not possible. This method may preserve hearing. The radiation may be given over several treatments or as one large dose.

A procedure called stereotactic radiosurgery may be used. This surgery uses a focused beam of radiation to destroy tumor tissue in and around the brain.

Prevention TOP

There are no current guidelines to prevent acoustic neuroma.

RESOURCES:

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

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

CANADIAN RESOURCES:

Canadian Academy of Audiology
https://canadianaudiology.ca

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

References:

Acoustic neuroma. American Hearing Research Foundation. Available at:
...(Click grey area to select URL)
Updated October 2012. Accessed September 5, 2017.

Acoustic neuroma. VEDA website. Available at:
...(Click grey area to select URL)
Accessed September 5, 2017.

What is acoustic neuroma? Acoustic Neuroma Association website. Available at: https://www.anausa.org/learn-about-acoustic-neuroma/what-is-acoustic-neuroma. Accessed September 5, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 3/17/2017

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