Acoustic Neuroma

Acoustic Neuroma

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An acoustic neuroma or vestibular schwannoma, is a benign (non-cancerous) tumor that arises on the (8 th cranial) nerve. This is the nerve that affects your hearing and balance. Acoustic neuromas usually grow slowly over a period of years. They expand in size at their site of origin and when large can displace normal brain tissue. The brain is not invaded by the tumor, but the tumor pushes the brain as it enlarges.

Causes

The causes of an acoustic neuroma are unknown however research has shown that there are people with certain risk factors who are more likely to develop this condition over those outside of the risk factors. These risk factors include:

  • Age
  • Family history of neurofibromatosis

Symptoms

Early symptoms of acoustic neuromas include partial hearing loss or complete hearing loss in one ear (this is usually subtle and worsens over time). More than 80% of patients have reported ringing in the ears ( tinnitus) described as high-pitched ringing, sometimes a machinery-like roaring or hissing sound. Since the balance portion of the nerve is where the tumor arises, unsteadiness and a disturbed sense of balance, and possibly vertigo with associated nausea and vomiting may occur during the growth of the tumor. Larger tumors can press on the trigeminal nerve, causing facial numbness and tingling - constantly or intermittently. Tumor related increase of intracranial pressure may cause headaches, clumsy gait and mental confusion. This can be a life-threatening complication requiring urgent treatment.

Even though the facial nerve (the nerve that moves the face) may be compressed by the tumor, it is unusual for patients to experience weakness or paralysis of the face from acoustic neuromas - although this may occasionally occur.

Diagnosis

Diagnosis of an acoustic neuroma begins with a full medical history of the patient to rule out any other conditions. After medical history is collected a physical examination will be done which may include an audiogram to evaluate the hearing in both ears. A brainstem auditory evoked response test may also be performed. This hearing test measures your brain's response to clicking sounds in your ear. This test helps determine whether the eighth cranial nerve is working and if your hearing and brainstem are functioning properly. If an acoustic neuroma is suspected, an MRI or CT scan will be performed to confirm the presence of a neuroma.

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