Acoustic neuroma
Overview
A neuroma is a tumour that arises from the cells of a nerve. An acoustic neuroma (vestibular schwannoma) is a non-cancerous (benign) tumour in the lining of the eighth cranial nerve that connects the inner ear with the brain. This is the nerve of balance and hearing.
Tumour growth
- Unilateral or asymmetric (one-sided) hearing loss
- Ringing in the ear (tinnitus)
- Dizziness.
Kinds of acoustic neuromas
There are two kinds of acoustic neuromas:
- Unilateral acoustic neuromas that affect only one ear and are the most common
- Bilateral acoustic neuromas that affect both ears and are rare. They usually occur before the age of 21 years.
Why is treatment important?
Even though acoustic neuromas are benign, they:
- Can significantly affect quality of life
- Have the potential to cause severe symptoms.
- The tumour is small and limited to the bony canal of the ear (intracanalicular) or
- The patient is over the age of 75.
The patient will not have any treatment and will be observed over time.
Once the tumour runs out of space inside the small canal that links the inner ear to the brain, it begins to grow into the skull cavity. If the tumour grows too quickly, the medical team may decide on proceeding with treatment.
Treatment considerations
The decision to treat an acoustic neuroma is guided by:
- A patient’s age
- The size of the tumour
- How fast the tumour is growing
- Symptoms the patient is experiencing.
The risks of the different treatments can be:
- Facial nerve impairment
- Trigeminal nerve impairment (mild to severe facial pain)
- Vertigo (feeling that one’s head is spinning) and imbalance
- Tinnitus (ringing in the ear)
- Hydrocephalus (build-up of fluid in the cavities inside the brain)
- Hearing loss.
The rates of these risks differ according to the treatment choice.
The decision requires a multidisciplinary specialist team to explain the benefits and the risks of the treatment options to the patient.
