Acoustic Neuroma

Acoustic neuroma — also called vestibular schwannoma — is a slow-growing, benign tumor that develops on the balance nerve (vestibular nerve) supplying the balance center of the inner ear.

Acoustic neuromas occur in approximately 1 out of every 100,000 people and make up about 10 percent of all tumors within the skull.

Causes of Acoustic Neuroma

Acoustic neuromas are believed to be caused by unregulated growth of Schwann cells lining the balance nerve. It was once thought that these tumors occurred on the hearing nerve (cochlear nerve) which transmits sound from the ear to the brain. We know now that they occur on the balance nerve, which sends balance information from the inner ear to the brain.

Most of these tumors develop spontaneously with no known cause. About 5 percent result from inherited genetic disorders.

While the media has reported that these tumors may be caused by cell phone use, these claims have not been proven.

Symptoms and Diagnosis of Acoustic Neuroma

The most common symptoms in patients with acoustic neuromas are slow and progressive hearing loss and tinnitus in just one ear.

Other symptoms can include vertigo and balance issues or a sudden change in hearing in one ear. In rare cases, facial numbness or facial spasms can occur.

At the Listen for Life Center, your ear specialist will do a thorough history and physical exam. Testing may include some combination of:

  • Specialized hearing tests
  • Balance testing including videonystagmogram (VNG), vestibular evoked myogenic potential (VEMP), and electrocochleography (ECoG)
  • Auditory brainstem-response testing (ABR)
  • MRI imaging, or CT scans for patients unable to undergo MRI

Because these tumors grow so slowly and often cause no symptoms, acoustic neuromas are also discovered unexpectedly in patients undergoing MRI or CT scans for unrelated reasons.

Treating Acoustic Neuroma

Fortunately, these tumors are benign and often small at the time of discovery. They grow slowly – usually only one to two millimeters per year on average. Many don’t grow at all, or grow so slowly they cannot be identified on MRI.

Treatment is individually tailored, based on a person’s age, general health, hearing status, symptoms associated with the tumor, and size of the tumor.

Treatment options include:

  • A “wait-and-scan” approach, which includes continued surveillance with regular imaging and audiometric testing
     
  • Microsurgical removal of the tumor via middle fossa craniotomy, translabyrinthine craniotomy, or retrosigmoid craniotomy
     
  • Stereotactic radiation therapy, during which radiation is precisely delivered to the tumor, sparing surrounding brain structures from unnecessary radiation

At the Listen for Life Center, our expert, multidisciplinary skull-base surgery team includes:

Each of our patients gets individualized care and input from this team, and our neurotologists make sure each patient understands all of the treatment options appropriate for them.

Three of our doctors, Drs. Farrokhi, Schwartz, and Zeitler, are part of the Acoustic Neuroma Association (ANA). The ANA is a patient-focused organization that provides information and networking support for patients before and after their treatment.