What is an acoustic neuroma (vestibular schwannoma)?
Acoustic neuromas, also known as a vestibular schwannomas, account for 8% of all primary brain tumours.
If you or someone you know has just been diagnosed with an acoustic neuroma, you may be worried about what this means. This is a natural way to feel. Our Support and Information team can help answer any questions you may have or provide a listening ear if you need one.
What is an acoustic neuroma?
Acoustic neuromas are low grade brain tumours that tend to affect adults between the ages of 30 to 60. Low grade brain tumours are slow growing and are sometimes referred to as benign.
They grow along one of the main cranial nerves in the brain, known as the acoustic or vestibulocochlear nerve.
The tumour grows from schwann cells, which wrap themselves around nerves to protect them and help with their function.
Acoustic neuromas are:
- slow growing
- rarely life threatening.
What are the symptoms of an acoustic neuroma?
As the acoustic nerve, along which these tumours grow, controls hearing and balance, common symptoms include:
Loss of hearing
The first symptom in 90% of cases, it’s often accompanied by ringing in the ear called tinnitus.
This loss usually progresses over time, but some people may experience a sudden loss of hearing. Others describe a feeling of ‘fullness’ in the affected ear.
Problems with balance
Sometimes called vertigo, you may get a feeling of your surroundings spinning. This can make you feel unsteady and have balance problems. It can occur during the growth of the tumour.
Larger acoustic neuroma tumours may lead to increased pressure in the brain, causing headaches and blurred or double vision.
If the tumour presses on the facial nerve (trigeminal nerve), it can cause facial numbness and tingling.
How are acoustic neuromas diagnosed?
Acoustic neuroma diagnosis can be difficult as their symptoms can be similar to other conditions. Diagnosis can also be delayed as hearing loss, may be put down to age-related hearing loss or exposure to high levels of noise earlier in life.
Acoustic neuromas are usually diagnosed after:
- routine auditory tests to reveal any loss of hearing and speech decline
- an audiogram to evaluate the level of hearing in both ears
- tests to check your sense of balance, reflexes and the strength in your arms and legs
- a diagnostic scan (usually an MRI), if there’s a noticeable loss of hearing in one ear.
How are acoustic neuromas treated?
Watch and wait
Some acoustic neuromas may not need immediate treatment, this is usually when they are small and not causing symptoms. If this is the case, you’ll usually be put on active monitoring (also called “watch and wait”) and you’ll see your specialist for regular check ups or MRI scans every 3, 6 or 12 months.
Surgery for acoustic neuroma
Neurosurgery is usually only used to remove larger acoustic neuroma brain tumours as it can result in the loss of hearing in the affected ear. Your surgeon will explain what is involved in the procedure and potential risks and complications. The surgeon may leave a small part of the tumour to prevent damage to the facial nerve. Any tumour cells that are left behind can be treated with stereotactic radiosurgery.
You may wish to discuss the possibility of having a ‘bone anchored hearing aid’ with your surgeon. This diverts sound from your affected ear to your good ear. Occasionally surgery can result in damage to the facial nerve, causing your face to droop on one side or difficulty in closing that eye.
Acoustic neuromas very rarely return after surgery, but you may continue to have regular MRI scans.
Even with treatment, symptoms such as tinnitus and hearing loss can persist. These symptoms will require additional treatment.
What treatment do people diagnosed with an acoustic neuroma have first?
If you’ve just been diagnosed with an acoustic neuroma and are about to have treatment, you may want to see what other people’s first treatment was. Use the First Treatment insight in BRIAN, which you can personalise to make it relevant to you.
What causes acoustic neuromas?
As with other brain tumours, the cause of most acoustic neuromas is unknown, although we do understand some of the risk factors involved.
It’s important to know that there is nothing you could have done, or avoided doing, that would have caused you or somebody you know to develop a brain tumour.
However, around 7% of cases are caused by a rare genetic disorder known as neurofibromatosis type 2 (NF-2).
NF-2 is a genetic condition that causes low grade tumours to grow along your nerves. It’s caused by a permanent change (mutation) in a gene that makes the growth of nerve tissue become uncontrolled. In half of all cases of NF-2, the mutation is passed from parent to child. There are genetic tests that can be carried out during pregnancy to test whether your child will have NF-2, but it’s normally diagnosed after birth.
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