An acoustic neuroma, also known as a vestibular schwannoma, is a noncancerous growth that develops on the eighth cranial nerve, which connects the inner ear to the brain. This nerve has two parts: one responsible for transmitting sound and the other for sending balance information from the inner ear to the brain.
Acoustic neuromas typically grow slowly over several years. While they do not invade the brain, larger tumors can press on it and nearby cranial nerves, potentially causing serious complications.
Early symptoms of an acoustic neuroma may be subtle and often attributed to normal aging changes. These symptoms include:
Gradual hearing loss in one ear
Ringing in the ear (tinnitus)
Feeling of fullness in the ear
Problems with balance
Vertigo (feeling like the world is spinning)
Facial numbness, tingling, or weakness
Taste changes
Difficulty swallowing and hoarseness
Headaches
Clumsiness or unsteadiness
Confusion
If you experience any of these symptoms, it's important to consult your doctor for an accurate diagnosis and appropriate treatment.
There are two types of acoustic neuroma:
Sporadic form (95% of cases): The cause is unknown, but exposure to high doses of radiation to the head and neck is a known risk factor.
Neurofibromatosis type II (NF2) associated form (5% of cases): An inherited disorder characterized by the growth of noncancerous tumors in the nervous system, often occurring in both ears by age 30.
The three main treatment options for acoustic neuroma are:
Periodic monitoring with MRI scans, suitable for slow-growing tumors causing no serious symptoms.
Removal of all or part of the tumor using one of three approaches:
Translabyrinthine (for tumors larger than 3 cm)
Retrosigmoid/sub-occipital (for tumors of any size, with the possibility of preserving hearing)
Middle fossa (for small tumors confined to the internal auditory canal, with the possibility of preserving hearing)
Delivered using state-of-the-art techniques to target the tumor while minimizing damage to surrounding tissue. Options include:
Single fraction stereotactic radiosurgery (SRS)
Multi-session fractionated stereotactic radiotherapy (FRS)
The choice of treatment depends on factors such as tumor size, growth rate, patient age, overall health, symptom severity, impact on quality of life, and whether the acoustic neuroma is associated with NF2 or is the sporadic form. NF2-associated tumors often require different treatment considerations due to the likelihood of bilateral tumors and the inherited nature of the condition. Your doctor will discuss the best options for your specific situation.
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