About Acoustic Neuroma

Tumors called acoustic neuromas develop along the nerve connecting the brain with the inner ear. They are a type of tumor called a schwannoma. Most acoustic neuromas arise for reasons that are not well understood. Like all schwannomas, acoustic neuromas do not metastasize (spread to other parts of the body). However, acoustic neuromas may require intervention as a result of their effect on the auditory nerves, the inner ear, and other tissue. Symptoms of an acoustic neuroma may include difficulty hearing, ringing in the ears, headache, dizziness, and loss of balance.

 

There are several options for acoustic neuroma treatment: observation, stereotactic radiosurgery, and various surgical approaches. Because the area is complex, these tumors vary, a patient’s goals vary, and each method has its advantages and drawbacks, treatment plans for acoustic neuromas are carefully personalized to each individual patient.

 

Acoustic neuromas are also known as acoustic neurinomas or vestibular schwannomas.

Dr. Michael Sisti shares what he knows about acoustic neuromas and how he treats them.

See Dr. Sisti’s publications on Acoustic Neuroma’s

Symptoms

Exact symptoms vary depending on a tumor’s size and location. An acoustic neuroma may cause:

  • Hearing loss, especially on one side; this is by far the most common symptom of acoustic neuroma
  • Tinnitus
  • Headache
  • Loss of balance
  • Vertigo
  • Facial numbness
Causes and Risk Factors

Most acoustic neuromas are not associated with any known risk factors.

Researchers have identified only one environmental risk factor for acoustic neuromas: exposure to ionizing radiation. This type of radiation is found naturally in the environment, as well as in X-rays and CT scans. It is not produced by microwaves or cell phones. However, exposure to ionizing radiation is not a factor in most cases of acoustic neuroma.

About 5 percent of acoustic neuromas are caused by a rare inherited condition called neurofibromatosis 2, or NF2. Though most patients with acoustic neuroma develop only one tumor, individuals with NF2 are likely to develop acoustic neuromas on both sides, and may develop other tumors as well.

Tests and Diagnosis

To diagnose an acoustic neuroma, a doctor will first take a medical history and conduct a neurological exam. The doctor may order or conduct a hearing test. If symptoms and results are suspicious for an acoustic neuroma, the doctor may order an imaging scan.

The scan that allows the most accurate diagnosis of acoustic neuroma is an MRI with gadolinium contrast enhancement. An MRI uses magnets, radio waves and a computer to create images of soft tissues such as nerves and tumors. Contrast enhancement is the injection of a dye (in this case, gadolinium) that makes even small amounts of tumor tissue stand out more clearly on the scan.

Surgical Treatment

Various treatment options exist for acoustic neuroma. Our neurosurgeons can help patients decide on the best treatment plan on an individual basis: observation, stereotactic radiotherapy or surgical removal.

Observation may be appropriate for small tumors that don’t cause symptoms. Patients and surgeons may also choose observation when the patient’s age or general health increases the risks of surgery.

Stereotactic radiosurgery may be appropriate for some tumors. This treatment uses highly focused beams of radiation to disrupt the tumor’s growth. Unlike conventional surgery, it does not require an incision, and patients are generally able to return to “normal life” quickly after the procedure. However, it may take months or years to see the full effect of radiosurgery. Regular follow-up scans are required.

Surgical removal is necessary in some cases. The goals of surgery are to prevent or relieve compression of the brainstem or cerebellum, to remove as much tumor as possible, to preserve hearing when possible and to preserve facial nerve function when possible. Our surgeons are experienced with several different surgical approaches, each of which has its own set of risks and benefits. When weighing surgical approaches, a neurosurgeon considers the tumor’s size and location, a patient’s general health and current symptoms, individual variations in blood flow and anatomy of the inner ear, and a patient’s treatment priorities.

Our experienced neurosurgeons can help you weigh the risks and benefits of all treatment options.

Dr. Michael Sisti, Dr. Grace Mandigo and Dr. Marc Otten and are experts in the treatment of acoustic neuroma. They can also offer you a second opinion.

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