What is an Acoustic Neuroma?

An acoustic neuroma, also known as a vestibular schwannoma, is a benign (non-cancerous) tumor that arises from balance nerves. Your brain receives auditory and balance information from your inner ear via the hearing and balance nerves.

The name “acoustic neuroma” is actually a misnomer, as the tumor most originates from the lining (or sheath, comprised of “Schwann cells”) of the balance (vestibular) nerves, rather than the neurons themselves. Therefore, the term “vestibular schwannoma” is used interchangeably with “acoustic neuroma.”

Acoustic neuromas typically grow slowly, resulting in hearing loss, ringing in the ear (tinnitus), balance problems, or other symptoms. Larger tumors, although uncommon, can be life-threatening.

Symptoms of Acoustic Neuroma

Because acoustic neuromas usually take years to grow, the symptoms may be gradual and sometimes go unnoticed. However, sudden hearing loss is possible. Its growth can affect nerves related to facial muscles and sensation, blood vessels, and the brain itself. Common signs of acoustic neuroma are:

  • Hearing loss (sudden or gradual)
  • Vertigo (sense of movement or “spinning”)
  • Loss of balance or unsteadiness
  • Ringing in one ear
  • Facial numbness

Causes of Acoustic Neuroma

The cause of acoustic neuroma is genetic, with a faulty gene on the 22nd chromosome that normally codes for a tumor suppressor protein. Without the full expression of this protein, the Schwann cells covering the vestibular nerve are allowed to grow unchecked. Risk factors for this gene switch have been linked to neurofibromatosis type 2 (NF2), an uncommon genetic disorder that is passed down from affected parents at a rate of 50%. Patients with NF2 develop acoustic neuromas in both ears, as well as other cranial nerve schwannomas, meningiomas, and other tumors.

When to See an Otolaryngologist

If you notice a degree of hearing loss, persistent ringing in your ear, or ongoing trouble with balance, you should make an appointment with an otolaryngologist in Denver as soon as possible. An otolaryngologist may refer you to a neurotologist, who is an otolaryngologist with subspecialty training in inner ear and skull base disorders. Acoustic neuroma and many other inner ear disorders are clinically treatable, and early diagnosis and treatment can prevent more significant symptoms from developing.

Acoustic Neuroma Diagnosis

During an appointment for acoustic neuroma, our otolaryngologists will first ask questions about your symptoms and medical history. Then, they will likely conduct a physical examination of the head and neck, an ear exam, and may order a number of additional tests. These may include but are not limited to:

  • Hearing test (Audiogram)
  • Imaging of the head and inner ear

During a hearing test, your audiologist will place special headphones over both ears and play a series of tones and/or words to assess your hearing ability. Imaging of the brain and the ear may be performed using a magnetic resonance imaging (MRI) machine or computed tomography (CT) scan, depending on your ability to undergo an MRI study.

Treating Acoustic Neuromas

Like many disorders of the inner ear, acoustic neuroma is a treatable condition. Upon diagnosing the condition, your otolaryngologist may offer three main management strategies: continued monitoring with repeat imaging, surgery, or radiation therapy.

The optimum treatment may be a difficult decision and is influenced by the size of the tumor, the presence of growth, your hearing ability, other associated symptoms (e.g., balance disturbance), and your overall health. There is often no “right” answer.

All treatment options have risks and benefits, and our providers will carefully review all management strategies with you so you can make a well-informed decision on your treatment plan.

Surgical Removal

In some patients, surgery is recommended. The goal of surgery is to completely or partially remove the tumor and address ongoing balance symptoms caused by the tumor. Neurotologists often work in collaboration with a neurosurgeon in order to remove the tumor.

Non-Surgical Techniques

Stereotactic radiation therapy refers to non-surgical procedures, such as Gamma Knife or CyberKnife radiosurgery, that target the tumor with a highly precise beam of radiation. Although successful in stopping tumor growth, radiation treatment does not remove the tumor, and imaging is required after treatment to ensure that the tumor does not continue to grow.

In addition, your provider may recommend vestibular therapy (balance therapy) and strategies to address your hearing loss (such as hearing aids) to help you return to a normal lifestyle.

ENT Services in Denver, CO

If you’re suffering from hearing loss or balance issues, it’s key to seek help from a hearing health professional to prevent your condition from deteriorating in the future or recognize a more serious condition. Our state and nationally certified providers are here to manage any hearing and balance condition and help you get your life back to normal. Contact us today by phone or online to schedule an appointment at our Denver, Lone Tree, or Castle Rock locations.

 

 

 

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