Patient's Complete Guide to Acoustic Neuroma

Overview of Acoustic Neuroma

The ear is the main organ of the human body that is responsible for hearing and balance. It consists of three main parts i.e. outer ear, middle ear and inner ear. A nerve called the Vestibular connects your inner ear with your brain. This nerve is involved in the hearing and maintenance of equilibrium (balance). Sometimes, a noncancerous tumour starts to grow on this nerve. This tumour is known as Acoustic neuroma or vestibular schwannoma. This condition can cause hair loss and unsteadiness.

Acoustic neuroma (صُوتی اعصابی پھوڑا/ Sooti asabi phora) commonly starts from the Schwann cells that cover the vestibular nerve. It usually grows slowly and does not invade the brain. If the tumour increases in size, it can press the facial muscles and brain stems.

Occurrence of Acoustic Neuroma

Acoustic neuromas are benign tumours diagnosed in 2,000 to 3,000 people every year, with an incidence of 1 per 100,000 per year.

Signs and Symptoms of Acoustic Neuroma

The early symptoms of acoustic neuroma are usually subtle. Mostly, people associate the symptoms with the usual changes of ageing. Therefore, its diagnosis takes time.

Some common symptoms of acoustic neuroma are:

  • Loss of hearing
  • A feeling of fullness in the ear
  • Ringing in the ear (tinnitus)

Some less common symptoms that appear over time include:

  • Balance issues
  • Facial weakness
  • Vertigo (feeling like the world is spinning)
  • Difficulty swallowing and hoarseness
  • Headaches
  • Facial numbness and tingling
  • Confusion
  • Taste changes
  • Clumsiness or unsteadiness

Types of Acoustic Neuroma

There are two types of acoustic neuroma on the basis of its effect:

  • Unilateral Acoustic Neuroma/Sporadic Form: In this condition, only one ear is affected. It is the most common type of acoustic neuroma. It can occur at any age but mostly affect between 30 and 60. It can be the result of nerve damage by environmental factors.
  • Bilateral Acoustic Neuroma: Bilateral acoustic neuroma affects both ears. It is a genetic disorder associated with a genetic problem called neurofibromatosis-2 (NF2). Therefore, it is also known as neurofibromatosis type II (NF2)

Causes of Acoustic Neuroma

The exact cause of acoustic neuroma is unknown; however, evidence suggests that it can be caused by:

  • Frequent and constant exposure to loud noise
  • Face exposure to radiation

Risk Factors of Acoustic Neuroma

Neurofibromatosis type 2 is the main risk factor of acoustic neuroma that is genetically inherited from parents. It is an autosomal dominant disorder, which means that mutation is inherited by only one parent. Therefore, each child has 50-50 chances of developing this disease. It only accounts for about 5% of acoustic neuroma cases.

Health-Related Complications of Acoustic Neuroma

An acoustic neuroma can lead to serious and permanent health disorders such as:

  • Ringing in the ear
  • Hearing loss
  • Difficulties with balance
  • Facial numbness and weakness

Prevention

Scientists reveal that there is no such way to prevent acoustic neuroma. They are searching for new ways to prevent the overproduction of Schwann cells (using gene therapy). 

Diagnosis

Diagnosis of acoustic neuroma is difficult because the symptoms are subtle and develop slowly. After inquiring about symptoms, the doctor will physically examine the ear. For acoustic neuroma following tests are performed:

  • Hearing Test (audiometry): This test is performed by a hearing specialist or an audiologist. The audiologist checks the hearing ability by playing sounds of different tones. This ability is also checked by presenting different words. 
  • Imaging: Imaging tests such as Magnetic resonance imaging (MRI) is performed for the confirmation of acoustic neuroma. This test can detect even smaller tumours that are 1 to 2 millimetres in diameter.

Treatment of Acoustic Neuroma | When to Consult a Doctor

Treatment approaches for acoustic neuroma vary, depending on the size of the tumour, the patient’s overall health and symptoms. To treat acoustic trauma doctors recommend following three potential procedures such as:

  • Monitoring

  • Your doctor recommends this test if the tumour is small and slow-growing. It is beneficial if you are unable to undergo a more aggressive treatment method. 
  • Monitoring is recommended for 6-12 months. If during this time the tumour grows in size and spreads, then you may need to undergo another treatment method.
  • Surgery

Surgery is performed to remove the tumour. In this method, the whole tumour is not removed especially if it is near the facial or other brain nerves. Surgery is performed under general anaesthesia. Sometimes it can result in complications such as:

  • Leakage of cerebrospinal fluid through the wound
  • Hearing loss
  • Stroke or brain bleeding
  • Ringing in the ear
  • Facial weakness
  • Facial numbness
  • Persistent headache
  • Balance problems
  • Infection of the cerebrospinal fluid (meningitis)
  • Radiation Therapy

  • Stereotactic radiosurgery is the type of radiation therapy that is used to treat acoustic neuroma. It is a preferable approach, if you're an older person and can’t undergo surgical procedures.
  • It is used to stop the growth of small-sized tumours. This procedure is beneficial as compared to others because during this facial nerves and hearing ability is not affected.

If you experience symptoms such as hearing loss, headache, ringing in the ear and balance problems seek immediate medical care and consult a hearing specialist.

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