Symptoms and Diagnosis of Acoustic Neuroma | Neurology

Acoustic neuroma

What is acoustic neuroma?

An acoustic neuroma, also known as a vestibular squamous cell, is a rare benign (cancer-free) growth that develops in the eighth cranial nerve. The tumor then balances the nerves in the ear and inner ear. Schwann cells generally surround and support nerve fibers.

Although there is no standard or distinctive pattern for symptomatic development, (unilateral) hearing loss in one ear is an early symptom in about 90 percent of affected people. Additional common results include ringing in the ears (tinnitus) and dizziness or asymmetry. 

Symptoms of acoustic neuroma occur when the tumor presses on the eighth cranial nerve and affects the brain’s ability to transmit nerve signals. This is not cancer (malignant); It does not spread to other parts of the body. The cause of the vestibular schwannoma shape is unknown.

Alternate name

  • Vestibular schwannoma

Types of acoustic neuroma

Types of acoustic neuroma include:

  • Unilateral acoustic neuromas: This type only affects one ear. This is the most common type of acoustic neuroma. This tumor can develop at any age. It occurs most often between the ages of 30 and 60. Acoustic neuroma can be caused by nerve damage caused by environmental factors. Radiation passed to the head is the only environmental risk factor. It is not clear whether prolonged exposure to loud noise can cause acoustic neuromas.
  • Bilateral acoustic neuromas: This type attacks both ears and is inherited. It is caused by a genetic disorder called neurofibromatosis-2 (NF2).

Causes of acoustic neuroma

For most acoustic neuromas, the cause is the failure of the “governor” gene to suppress the growth of Schwann cells at the cellular level, causing those cells to cover nerve fibers with insulation. Without repression, these cells turn into pimples to produce neuromas.

Exposure to radiation to the head is an environmental impact that is strictly connected with an increased frequency of vestibular schwannoma. There is currently no evidence of an association between cell phone use and the development of these tumors.

Acoustic neuroma is generally not considered a hereditary disease; However, five percent of cases are associated with a genetic disorder called neurofibromatosis type 2 (NF2). These individuals show two-sided vestibular tumors that are frequently associated with other tumors around the brain and/or spine.

Symptoms of acoustic neuroma

Symptoms of acoustic neuroma include:

  • Hearing failure on one side, can’t listen to high-frequency sounds
  • The sense of fullness in the ear
  • Buzzing in the ear (tinnitus), on the side of the tumor
  • Dizziness
  • Balance problems or unsteadiness
  • Facial numbness and tingling with feasible, though rare, insensibility of a facial nerve
  • Headaches, clumsy gait, and mental confusion

The symptoms of acoustic neuroma appear to be similar to those of other conditions or health problems. Always speak with your healthcare provider to get a diagnosis.

Diagnosis of acoustic neuroma

A doctor will run a test and ask the person about their symptoms.

The best test to diagnose acoustic neuroma is an MRI of the brain. An MRI uses a strong magnetic field and radio waves to take a detailed picture of your brain and its structures. It is painless, but it makes noise and makes you anxious to “get close” (claustrophobic).

To rule out dizziness, hearing loss, or other causes of vertigo, the person may undergo a hearing test, a balance test, and a brain system function test.

Other problems with similar symptoms include:

  • Meningioma, a tumor that expands on the brain lining
  • Meniere’s disease
  • Neuritis, an inflammation of the nerves
  • Atherosclerosis, when the blood vessels narrow

Treatment for acoustic neuroma

For small tumors, doctors may recommend that no action be taken without regular checkups. This is because verbal neuroma generally develops slowly in the early stages.

Acoustic neuromas grow very slowly and do not cause any symptoms for a long time. Remember, acoustic neuromas are not cancerous (malignant) and they don’t spread, so it’s safe to look at things for a while. Also, treatments can cause problems and side effects. Therefore, the risks and benefits of treatment must be balanced. If an exam is recommended, your condition will be monitored with regular scans.

If the tumor shows signs of growth or puts pressure on the brain system, radiation or surgery may be needed. The choice between the two depends on many factors that are best discussed with your surgeon and radiation oncologist. Factors such as tumor size and location, related health problems, age, and hearing impairment need to be considered.

Surgery

Depending on the size and location of the vestibulocochlear nerve in the brain, a neurosurgeon or an ENT surgeon can work to remove the verbal neuroma. The surgery is done under general anesthesia.

Most people with acoustic neuroma are treated surgically. Although the goal is to completely remove the tumor, sometimes a small part of the tumor is left behind. This is usually because the entire tumor is technically very difficult to remove and/or there is a risk of further damage to the nerves or other nearby structures.

If some acoustic neuromas remain, they can often be treated with radiation therapy. After surgery for an acoustic neuroma, you may need to stay in the hospital for a few days for monitoring. You should make a full recovery in 6 to 12 weeks, and if the tumor is completely removed, no further treatment is needed.

Radiation therapy

This is a non-surgical procedure that is often done on a patient basis. Radiation can be given in a single dose or in multiple or different doses.

Radiation therapy (more than one session) or radiation therapy (single session) are useful therapies in inappropriate situations. In general, the genetic material of the radiation cell induces strand breaks in DNA. In theory, it can cause cell death and/or growth arrest in some parts of the tumor.

Complications

Several complications can arise, including:

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

Large tumors that block the normal flow of fluid between your brain and spinal cord (cerebrospinal fluid) can put pressure on your brain system. In this case, fluid can make up in your head (hydrocephalus), improving the pressure inside your skull.

Prognosis

Acoustic neuromas are not malignant and do not spread to other parts of the body. Prompt diagnosis and proper treatment can reduce risks and reduce life expectancy.

Departments to consult for this condition

  • Department of Neurology

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