Acoustic Neuroma: Symptoms, Causes, Treatment

What are the symptoms of acoustic neuroma?

Acoustic neuroma, also known as vestibular schwannoma, is a benign (noncancerous) tumor that develops on the vestibular nerve, which connects the inner ear to the brain. Symptoms of acoustic neuroma can vary depending on the size and location of the tumor. Common symptoms may include:

1. Hearing loss: Gradual hearing loss in one ear is often the first symptom of acoustic neuroma. This hearing loss is typically gradual and may be accompanied by a feeling of fullness in the affected ear.
2. Tinnitus: Ringing, buzzing, or hissing sounds in the affected ear, which may come and go or be continuous.
3. Vertigo or imbalance: Episodes of dizziness, spinning sensation (vertigo), or imbalance, which may be mild or severe.
4. Facial numbness or weakness: Rarely, acoustic neuroma can cause compression of the facial nerve, leading to numbness, weakness, or paralysis of the face.
5. Headaches: Dull, persistent headaches, particularly around the temple or behind the ear, may occur in some cases.
6. Difficulty with coordination: Larger tumors may compress the brainstem, leading to problems with coordination and balance.
7. Changes in vision: Pressure from a large tumor can affect the nerves responsible for eye movement, causing double vision or other visual disturbances.
8. Swallowing difficulties: Rarely, a large tumor may compress the nerves involved in swallowing, leading to difficulty swallowing (dysphagia).

Symptoms of acoustic neuroma can be subtle and may be mistaken for other conditions. It’s important to see a healthcare provider if you experience any persistent or concerning symptoms, especially hearing loss or balance problems. Early diagnosis and treatment of acoustic neuroma can help prevent complications and preserve hearing and facial function.

What are the causes of acoustic neuroma?

The exact cause of acoustic neuroma is not known, but it is believed to occur due to a combination of genetic and environmental factors. Acoustic neuromas develop from a type of cell called Schwann cells, which normally wrap around and insulate nerve fibers. In the case of acoustic neuroma, Schwann cells on the vestibular nerve grow abnormally and form a tumor.

Some factors that may contribute to the development of acoustic neuroma include:

1. Neurofibromatosis type II (NF2): This rare genetic disorder increases the risk of developing acoustic neuromas, usually at a younger age. NF2 is caused by mutations in the NF2 gene, which is responsible for suppressing tumor growth.
2. Exposure to radiation: Previous exposure to high-dose radiation therapy to the head or neck may increase the risk of developing acoustic neuroma, although this is rare.
3. Age: While acoustic neuromas can occur at any age, they are most commonly diagnosed between the ages of 30 and 60.
4. Gender: Acoustic neuromas are slightly more common in women than in men.
5. Genetics: In some cases, acoustic neuromas occur sporadically without a known genetic cause. However, there may be a genetic predisposition in some individuals.
6. Environmental factors: While not well understood, some environmental factors may play a role in the development of acoustic neuroma.

It’s important to note that most cases of acoustic neuroma occur sporadically, meaning they occur without a clear genetic or environmental cause. However, individuals with a family history of neurofibromatosis type II or a personal history of radiation therapy to the head or neck may have an increased risk of developing acoustic neuroma and should be monitored regularly by a healthcare provider.

What is the treatment for acoustic neuroma?

The treatment for acoustic neuroma depends on several factors, including the size and growth rate of the tumor, the severity of symptoms, and the individual’s overall health and preferences. Treatment options may include:

1. Monitoring: Small, slow-growing tumors that are not causing significant symptoms may be monitored over time with regular MRI scans. This approach, known as “watchful waiting” or “active surveillance,” is often used for older adults or individuals with underlying health conditions that make surgery or radiation therapy risky.
2. Surgery: Surgical removal of the tumor, known as microsurgery or craniotomy, may be recommended for larger tumors or those causing severe symptoms. The goal of surgery is to remove as much of the tumor as possible while preserving facial nerve function and hearing. However, surgery carries risks, including damage to the facial nerve, hearing loss, and other complications.
3. Radiation therapy: Radiation therapy, such as stereotactic radiosurgery (e.g., Gamma Knife), may be recommended for small to medium-sized tumors or for individuals who are not good candidates for surgery. Radiation therapy uses focused beams of radiation to target and shrink the tumor over time. This approach is often used to preserve hearing and facial nerve function.
4. Medication: In some cases, medications may be prescribed to manage symptoms such as dizziness, vertigo, or facial pain. These medications do not treat the tumor itself but can help improve quality of life.

The choice of treatment depends on several factors, including the size and location of the tumor, the individual’s age and overall health, and the severity of symptoms. It’s important for individuals with an acoustic neuroma to discuss treatment options with a healthcare provider or a team of specialists to determine the most appropriate course of action based on their specific situation.

Can an acoustic neuroma go away on its own?

Acoustic neuromas, also known as vestibular schwannomas, are typically slow-growing tumors. In some cases, especially for small tumors, they may remain stable or even shrink slightly over time without treatment. However, it is uncommon for an acoustic neuroma to completely disappear on its own.

For many acoustic neuromas, especially those that are symptomatic or growing, treatment may be recommended to prevent further growth and potential complications. Treatment options may include surgery, radiation therapy, or active surveillance (regular monitoring with MRI scans).

It’s important for individuals with an acoustic neuroma to work closely with a healthcare provider or a team of specialists to monitor the tumor’s growth and determine the most appropriate course of action based on their specific situation. Regular monitoring with MRI scans is typically recommended to track any changes in the tumor’s size or growth rate.