An acoustic neuroma (vestibular schwannoma) is a benign tumor that grows in the Schwann cells covering the vestibular nerve, which leads from the inner ear to the brain. These slow-growing tumors do not spread throughout the body but they can grow large enough to press on the brain or brainstem, which can cause severe symptoms. Acoustic neuromas are most common in adults between ages 40 and 50, although they can occur at any age.
The majority of acoustic neuromas develop by chance without a known cause. There are studies suggesting a malfunctioning gene on chromosome 22, but the triggers for the gene malfunctions are not known.
In a small percentage of patients, acoustic neuromas can be related to neurofibromatosis type 2 (NF2), a rare genetic disorder. NF2 is an inherited genetic disorder known to cause acoustic neuromas on both sides of the head as well as benign nerve tumors throughout the body.
Common symptoms of acoustic neuromas
Acoustic neuromas can grow and put pressure on the vestibular and cochlear nerves. Hence hearing loss, ringing in your ear and unsteadiness are the most common symptoms, which is why most symptoms of acoustic neuromas relate to these two functions. Occasionally, the tumor may become large enough to put pressure on brain structures and cause weakness or changes in normal body function. Symptoms include:
- Hearing loss in one ear
- Tinnitus in one ear
- Dizziness (vertigo)
- Balance problems
- A feeling of fullness in one ear
- Facial numbness, and rarely, facial weakness
- Persistent headaches and mental confusion
Many of these symptoms also occur along with the natural aging process and are not necessarily indicative of an acoustic neuroma. Even so, it’s important to speak with a physician who can determine the cause.
Diagnosing acoustic neuromas
Early diagnosis offers the best opportunity for successful treatment. The diagnosis of acoustic neuromas may be difficult though because the symptoms of balance and hearing problems resemble other conditions of the middle and inner ear. Initial testing includes an ear examination and hearing test, yet the definitive diagnosis is achieved with CT and MRI scans. MRI scans can provide more details on tumor size and location, information that leads to proper treatment plans.
Moffitt Cancer Center’s approach to treating acoustic neuromas
Acoustic neuroma treatment can vary based on the size of the tumor and the patient’s age and general health. In some cases, monitoring the tumor is the recommended course of action. This is common for patients with small tumors that cause few to no symptoms, and also for older patients who may not be candidates for more aggressive treatment.
Other treatment options include radiation therapy and highly specialized surgery to remove the tumor while preserving hearing and the facial nerve. Our physicians always balance against the potential side effects related to the treatment and rehabilitation options to manage it.
The observation and monitoring strategy may be considered as the initial step in some acoustic neuromas. It is a common option for elderly patients or patients with no symptoms and diagnosis of a small tumor after having an imaging scan for an unrelated health condition. If serial scans show tumor growth or if symptoms arise, the patient may need to undergo treatment.
At Moffitt Cancer Center, our Neuro-Oncology Program consists of experienced physicians who specialize in medical oncology, radiation oncology, neurosurgery and clinical psychology, allowing us to provide a comprehensive range of acoustic neuroma treatment in a single location. Our patients are treated as individuals, and our specialists will closely review your case to ensure you receive the highest caliber of medical attention and treatment that meets your unique needs.
Medically Reviewed by Andre Beer Furlan, MD, PhD, skull base and endovascular neurosurgeon.
If you have been diagnosed with an acoustic neuroma and would like to learn more about your treatment options, you can request an appointment at Moffitt by calling 1-888-663-3488. You can also submit a new patient registration form online to arrange a consultation with our team.