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Acoustic neuroma : Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors , Complications , Prevention

 What Is Acoustic Neuroma?

An acoustic neuroma, additionally called a vestibular schwannoma, is a non-cancerous tumor that occurs around your balance and hearing nerves that join your internal ear along with your mind.


The term schwannoma way the tumor advanced from Schwann cells. These cells surround nerves in the peripheral worried gadget (nerves outside the brain and spinal cord) and generally insulate and support the function of nerves. Schwannomas can occur in nerves throughout the frame, however in the head, these maximum usually occur from the vestibular nerve, or balance nerve.

An acoustic neuroma is a form of non-cancerous (benign) brain tumor. It's additionally called a vestibular schwannoma.

A benign mind tumor is an increase inside the brain that usually grows slowly over many years and does not now spread to other components of the frame.

Acoustic neuromas develop on the nerve used for listening to and stability, that could reason problems including hearing loss and unsteadiness.

They can sometimes be severe if they emerge as very big, but most are picked up and dealt with earlier than they reach this degree.

Acoustic neuromas generally tend to have an effect on adults aged 30 to 60 and normally haven't any apparent cause, despite the fact that a small wide variety of cases are the result of a genetic condition known as neurofibromatosis kind 2 (NF2).


What Is Acoustic Neuroma?


medical terms

  • Acoustic Neuroma is a type of tumor that develops on the vestibulocochlear nerve also known as the 8th cranial nerve. This nerve connects the inner ear to the brain, and it is responsible for hearing, balance, and facial movements. Typically, an acoustic neuroma is benign, meaning it does not spread or become malignant. However, if untreated, it can grow and cause complications by putting pressure on the surrounding nerves and brain tissue.

  • Acoustic neuroma is a benign tumor that emerges from the nerves in the inner ear. It can affect the hearing and the balance of the affected person. It is not cancerous and rarely metastasize, but it can cause serious damage if it isn't treated. It is important to seek medical attention when you experience any symptoms related to an acoustic neuroma, such as tinnitus or hearing loss.

  • Acoustic neuroma is a noncancerous tumor that develops on the main nerve leading from your inner ear to your brain. This can cause problems with your balance and hearing. Decoupage can cause ringing in your ears and unsteadiness.

  • Acoustic neuroma usually develops from the Schwann cells that cover this nerve and grows slowly or not at all. Rarely, it may grow rapidly and become large enough to press against the brain and interfere with vital functions.

  • Acoustic neuroma can be treated with regular monitoring of radiation and surgical removal.

  • An acoustic neuroma, additionally known as a vestibular schwannoma, is an extraordinary benign (non-cancerous) growth that develops on the 8th cranial nerve. This nerve runs from the internal ear to the mind and is liable for hearing and stability (equilibrium). Although there may be no well known or common pattern of symptom improvement, hearing loss in a single ear (unilateral) is the preliminary symptom in about 90 percent of affected individuals. Additional not unusual findings include ringing inside the ears (tinnitus) and dizziness or imbalance. The signs of an acoustic neuroma occur from the tumor pressing towards the 8th cranial nerve and disrupting its capability to transmit nerve indicators to the mind. An acoustic neuroma isn't always cancerous (malignant); it does not unfold to different elements of the body. The reason an acoustic neuroma forms is unknown.

  • Acoustic neuroma is a noncancerous tumor that develops on the auditory nerve in the brain It can arise as a single tumor or in multiple tumors called acoustic neuromas Acoustic neuroma tumors cause hearing loss and facial paralysis Treatment for acoustic neuroma includes surgery radiation therapy and chemotherapy according to the Mayo Clinic Surgery is the most common treatment for acoustic neuroma because it removes some of the tumor's pressure from surrounding brain tissue Radiation therapy kills cancer cells with the use of high-energy X-rays while protecting healthy cells The purpose of chemotherapy is to kill cancer cells throughout the body.

  1. Sensory organs

Sensory organs are the collection of sensory receptors and other neural mechanisms that responds to external stimuli in the environment. There are many different types of sensory receptors that respond to various modalities of stimuli, including light, sound, touch, temperature, pressure, and chemicals. The mechanisms by which these receptors transduce the energy of the stimulus into a neural signal that can be processed by the brain are also quite varied.

  1. Ear

  2. Outer ear

  3. Earlobe

  4. Eardrum

  5. Middle ear

  6. Ossicles

  7. Inner ear

  8. Cochlea

  9. Vestibule of the ear

  10. Semicircular canals

Types of  Acoustic neuroma

There are two types of acoustic neuromas:

  • Sporadic, unilateral acoustic neuromas. These tumors only grow on one facet of the frame in 95% of patients. They occur from sporadic (sudden), nonhereditary mutations. These unilateral acoustic neuromas may additionally broaden at any age, but maximum generally occur in humans among the ages of 30 and 60.

  • Genetic, bilateral acoustic neuromas. Acoustic neuromas on each facet of the frame only arise in people who've the genetic disorder neurofibromatosis kind 2, a mutation in chromosome 22 that influences the gene accountable for manufacturing of Schwann cells. These sufferers often produce other schwannoma-like tumors during the body, and treatments for those tumors are regularly special from the treatment for unilateral tumors.

Symptoms Acoustic neuroma

  • Some individuals, mainly people with small tumors, may not have any associated signs and symptoms (asymptomatic). However, even small tumors, relying upon their place, can reason giant signs and symptoms or bodily findings.
  • Acoustic neuromas are sluggish-growing tumors that could eventually cause an expansion of signs and symptoms by pressing against the eighth cranial nerve. Hearing loss in one ear (the ear affected by the tumor) is the initial symptom in about ninety percent of patients. Hearing loss is usually slow, even though in a few uncommon cases it is able to be surprising. In a few instances, hearing loss can also differ (get worse and then improve). Hearing loss may be observed by using ringing inside the ears, a condition referred to as tinnitus, or with the aid of a feeling of fullness within the affected ear. In a few instances, affected individuals may additionally have issue know-how speech that is disproportional to the quantity of hearing loss.
  • Acoustic neuromas can also cause dizziness and troubles with stability which includes unsteadiness. In rare instances, dizziness or balance issues may additionally occur before substantial listening to loss. Because these tumors normally develop very slowly, the body can often make amends for these stability problems.
  • Although slow-developing, acoustic neuromas can finally turn out to be large enough to press towards neighboring cranial nerves. While uncommon, signs as a result of the involvement of different cranial nerves include facial weak spot or paralysis, facial numbness or tingling, and swallowing difficulties. Facial numbness or tingling may be constant or it may come and move (intermittent).
  • In some sufferers, acoustic neuromas may grow big enough to press in opposition to the brainstem, stopping the everyday go with the flow of cerebrospinal fluid among the mind and spinal twine. This fluid can accumulate in the skull, leading to a phenomenon referred to as hydrocephalus, which causes stress at the tissues of the brain and results in a spread of signs and symptoms which includes headaches, an impaired ability to coordinate voluntary actions (ataxia), and intellectual confusion. Headaches may additionally occur in the absence of hydrocephalus and in a few uncommon instances may be the primary signal of an acoustic neuroma. In very uncommon cases, an untreated acoustic neuroma that presses on the brain can cause life-threatening headaches.
  • Acoustic neuroma often goes undetected for many years, and its symptoms can include problems with hearing and balance. The tumor may pressure nearby nerves that control facial muscles and sensation (facial and trigeminal nerves). If you are near a blood vessel or brain structure, it may cause problems.

If the tumor grows, it may cause more obvious or severe signs and symptoms.

Some signs and symptoms of acoustic neuroma may include:

  • Hearing loss often gradually worsens over months to years, although in rare cases it can suddenly worsen. It may occur on only one side, or be more severe on one side.

  • Ringing (tinnitus) in the affected ear

  • Unsteadiness or loss of balance

  • Dizziness (vertigo)

  • If someone experiences facial numbness or weakness, or if they lose muscle movement, it means they are very sick.

There are rare cases where an acoustic neuroma can grow large enough to compress the brainstem and become life-threatening.

When to see your doctor

If you are experiencing hearing loss in one ear and ringing or trouble with your balance, see your doctor.

If acoustic neuroma is diagnosed early, the tumor may not grow large enough to cause serious consequences such as total hearing loss.

Causes Acoustic neuroma

Acoustic neuromas can be linked to a problem with a gene on chromosome 22. Normally this gene produces a tumor suppressor protein that helps control the growth of Schwann cells that cover the nerves.

It is not known what causes this problem with the gene. In most cases of acoustic neuroma, there is no known cause. This faulty gene is also inherited in neurofibromatosis type 2, a rare disorder that usually involves the growth of tumors on the hearing and balance nerves on both sides of your brain. A bilateral vestibular schwannoma is a tumor on either side of the brain.

Researchers do not understand why acoustic neuromas form. Most of the time, the tumors stand up spontaneously — without an acknowledged cause or purpose. For a small institution of humans, the acoustic neuroma develops as a part of NF2.

Risk factors Acoustic neuroma

Neurofibromatosis type 2

Acoustic neuroma is not caused by any one specific factor, but rather it is more likely to occur in people who have a parent with the rare genetic disorder neurofibromatosis type 2. However, neurofibromatosis type 2 only accounts for about 5% of acoustic neuroma cases.

Neurofibromatosis type 2 is characterized by the development of noncancerous tumors on the hearing and balance nerves on both sides of the head as well as other nerves.

Neurofibromatosis type 2 is a disorder that is caused by a mutation on one of the two autosomes. This means that it can be passed down from just one parent (the dominant gene). Each child of an affected parent has a 50-50 chance of inheriting the condition.

Complications Acoustic neuroma

If untreated, an acoustic neuroma can grow big enough to cause pressure on the brain stem. The tumor can block the drift of cerebrospinal fluid (CSF) among the mind and the spinal twine, inflicting a buildup of the fluid inside the mind.


Because the skull is a closed structure, excess fluid in the brain (hydrocephalus) can press in opposition to the brain, causing unsteady motion and absence of coordination (ataxia), complications and confusion.

A neuroma (a tumor of the nerve) may cause a variety of permanent complications, including:

  • Hearing loss

  • Facial numbness and weakness

  • Difficulties with balance

  • Ringing in the ear

If you have a large tumor pressing on your brainstem, this may prevent the normal flow of fluid between your brain and spinal cord (cerebrospinal fluid). This can cause fluid to build up in your head (hydrocephalus), which can increase the pressure inside your skull.

Prevention Acoustic neuroma

You can not save your acoustic neuromas from growing. But you may reduce your hazard of headaches by means of listening to the way you experience and feature. If you hear any signs and symptoms such as listening to loss, dizziness or ringing in your ears, don’t disregard your concerns.


Talk to your healthcare issuer who can carry out a full diagnosis and get to the lowest of your signs. The earlier an acoustic neuroma is detected, the better the probabilities for complete tumor elimination and listening to protection.

What is the best treatment for acoustic neuroma?

Treatment options for acoustic neuroma vary depending on the type and size of the tumor For small tumors surgeons can remove the tumor leaving behind some hearing and nerve function If a patient's tumor is larger or has grown into surrounding brain tissue then a surgeon may opt to remove part of the skull to access the tumor The goal of surgery is to remove as much of the tumor as possible while preserving any remaining hearing Patients who undergo this surgery will generally receive chemotherapy or radiation therapy after surgery in order to prevent the growth of new tumors.

Can acoustic neuroma go away?

If you are diagnosed with an acoustic neuroma in your ear it is important to be aware that this is a tumor and generally will not go away without treatment However there are some cases where the tumor shrinks or stops growing over time This usually happens when: The acoustic neuroma is located in the lower part of the brain stem This is because tumors in the lower part of the brain stem tend to grow slowly and may even stop growing over time You have no symptoms related to the acoustic neuroma This can happen if you have a small tumor on your ear nerve or another type of benign tumor which does not cause any symptoms You may have this type of tumor for years before you know it.

Is acoustic neuroma serious?

Acoustic neuroma is a noncancerous tumor that develops on the nerve connecting the ear to the brain It occurs in approximately 1 in 50,000 people Acoustic neuromas are more common among women than men Symptoms of acoustic neuroma include: Hearing difficulties such as tinnitus (ringing in the ears) and hearing loss Headaches Balance problems or dizziness Facial weakness or paralysis on one side of the face Problems with speech.

What is the survival rate for acoustic neuroma?

Acoustic neuroma is a benign tumor that develops on the nerve that connects the inner ear with the brain While most acoustic tumors are noncancerous there is also a risk of developing cancer Treatment depends on the size and location of the tumor Surgery is often used to remove acoustic tumors There is currently no standard way to treat acoustic tumors but research is ongoing to find new treatments for this condition.

Do acoustic neuromas grow back?

Acoustic neuromas are noncancerous tumors that develop on the cranial nerves They can cause hearing loss and tinnitus which is a ringing sound in the ear The good news is that acoustic neuromas grow slowly meaning they usually cause mild symptoms However all tumors have the potential to grow back once they have been removed through surgery.

Diagnosis Acoustic neuroma

  • A diagnosis of an acoustic neuroma is made primarily based upon a radical clinical assessment, an in depth affected person records, identity of feature findings and a selection of specialized assessments. Such assessments encompass hearing assessments, x-ray scans inclusive of magnetic resonance imaging (MRI) or computed tomography (CT), a specialized take a look at that evaluates balance (electronystagmography), and a brainstem auditory evoked response (BAER).
  • An MRI uses a magnetic subject and radio waves to supply go-sectional images of particular organs and physical tissues. During CT scanning, a laptop and x-rays are used to create a film displaying move-sectional snap shots of positive tissue systems. MRIs are the maximum sensitive look at to verify the presence of an acoustic neuroma.
  • An electronystagmography test evaluates stability with the aid of detecting atypical, involuntary eye movements, a condition called nystagmus. Nystagmus might also arise because of internal ear headaches inclusive of an acoustic neuroma.
  • A BAER exam assesses hearing and neurological features and interplay by recording the brain’s reaction to sure sounds. Since an acoustic neuroma can disrupt the nerve pathway that relays sound from the ear to the brain, a superb end result of a BAER examination might be as a result of those tumors.
  • An acoustic neuroma ear exam is scheduled at the Mayo Clinic.
  • A physical exam and an ear exam are often the first steps in diagnosing acoustic neuroma.
  • Some of the things in this content were created before the COVID-19 pandemic, and they don't follow proper pandemic protocols. Follow all recommended Centers for Disease Control and Prevention guidelines when wearing a mask and staying away from other people.
  • Acoustic neuroma is often difficult to diagnose early on, as signs and symptoms may be subtle and develop slowly over time. Common symptoms such as hearing loss are also common among other middle and inner ear problems.

Your doctor will ask about your symptoms and perform some tests. These tests may include an ear exam.

  • Hearing test (audiometry).In this test, a hearing specialist will present sounds to one ear at a time. The specialist will also present sounds of various tones at faint levels in order to find out when you can barely hear them.
    The audiologist may present various words to determine your hearing ability.

  • Imaging. Acoustic neuroma can usually be diagnosed by using a magnetic resonance imaging scan with contrast. This test can detect tumors that are as small as one to two millimeters in diameter. If MRIs are not available or you cannot have an MRI scan, a computerized tomography scan may be used. However, this test is more expensive and may not be necessary in some cases. CT scans may not be able to detect very small tumors.

Treatment Acoustic neuroma

There are numerous special treatment alternatives for an acoustic neuroma, relying on the scale and position of your tumor, how rapid it's developing and your fashionable health.

 Clinic offers surgery for acoustic neuroma.

There are several acoustic neuroma treatment options at Mayo Clinic, such as surgery by an experienced neurosurgeon.

Your treatment for an acoustic neuroma will vary depending on your symptoms and medical history.

  • The size and growth of the acoustic neuroma will be determined by the amount of pressure applied to the tumor.

  • Your overall health

  • Severity of symptoms

Your doctor may suggest one or more of three potential treatments for acoustic neuroma: monitoring surgery or radiation therapy, or a combination of the two.

Monitoring

If you have a small acoustic neuroma that is not growing or is growing slowly, and does not cause any symptoms or signs, your doctor may decide to monitor it. Monitoring may be recommended for people who are older or otherwise not good candidates for more aggressive treatment.

Your doctor may recommend that you have regular imaging and hearing tests to see if the tumor is growing and how quickly. If the scans show that the tumor is growing or if symptoms from the tumor are progressing, you may need to undergo additional testing. Treatment

Surgery

If you have an acoustic neuroma, you may need surgery to remove it. Acoustic neuromas are especially dangerous if they are large or located near other vital organs.

  • Continuing to grow

  • Very large

  • Causing symptoms

Your surgeon may use one of several techniques to remove an acoustic neuroma, depending on the size and status of your tumor.

The goal of surgery is to remove the tumor and prevent facial paralysis. Sometimes it is not possible to completely remove the tumor, depending on the location and size of the tumor.

Acoustic neuromas are treated with surgery, which is done under general anesthesia. The tumor is removed through the inner ear or through a window in your skull.

If surgery is needed to remove a tumor, it may worsen symptoms if the hearing or facial nerve is damaged. Hearing may be lost on the side where the surgery was performed, and balance usually suffers for a short time.

Complications may include:

  • Wound or nose bleeding

  • Hearing loss

  • Facial weakness or numbness

  • Ringing in the ear

  • Balance problems

  • Persistent headache

  • Meningitis is a rare infection of the cerebrospinal fluid.

  • Very rarely, stroke or brain bleeding

Radiation therapy

Radiation therapy is used to treat acoustic neuroma in several ways.

  • Stereotactic radiosurgery.If your doctor thinks that radiation therapy will be effective for treating your cancer, he may recommend stereotactic radiosurgery. This type of radiation therapy is often used if the tumor is small (less than 2.5 cm in diameter), you are over the age of 50, or you cannot tolerate surgery.
    Radiosurgery such as Gamma Knife therapy uses many tiny gamma rays to deliver a precisely targeted dose of radiation to a tumor.Stereotactic radiosurgery is used to stop the growth of a tumor, preserving facial nerve function and possibly preserving hearing.You may not see any effects from radiosurgery for weeks, months, or even years. Your doctor will monitor your progress with follow-up imaging studies and hearing tests.Risks of radiosurgery include:

    • Hearing loss

    • Ringing in the ear

    • Facial weakness or numbness

    • Balance problems

    • Continued tumor growth

  • Stereotactic radiotherapy.Stereotactic radiotherapy (SRT) delivers a small dose of radiation to the tumor over several sessions. This technique is used to curb the tumor's growth without damaging surrounding brain tissue.

  • Proton beam therapy.This type of radiation therapy uses high-energy beams of positively charged particles called protons. These particles are delivered to the affected area in targeted doses to treat tumors and minimize radiation exposure to the surrounding area.

Supportive therapy

If your doctor removes or stops the growth of a tumor, they may also recommend supportive therapies to help you with symptoms or complications, such as dizziness or balance problems.

Hearing loss can be treated with cochlear implants or other treatments.

If you are having trouble with your acoustic neuroma, visit Mayo Clinic for help. They will provide you with supportive care.

Physical therapy, occupational therapy, and hearing assistance are part of the comprehensive acoustic neuroma treatment at Mayo Clinic. These treatments help to support the patient's balance (vestibular) and physical abilities (physical therapy), as well as their ability to work (occupational therapy) and hear (hearing assistance).

  1. Hearing rehabilitation

Coping and support

When facing the possibility of hearing loss or facial paralysis, it can be quite stressful. Here are some things to keep in mind if you're feeling stressed:

  • Educate yourself about acoustic neuroma. The more information you have, the better prepared you will be to make good decisions about treatment. Besides talking to your doctor and your audiologist, you may want to talk to a counselor or social worker. Or you may find it helpful to talk to other people who have had an acoustic neuroma and learn more about the condition. Some of the patients interviewed shared their experiences during and after treatment.

  • Maintain a strong support system.Your family and friends can be there to help you through this difficult time, but sometimes you may find the support and understanding of others with acoustic neuroma comforting.
    Your doctor or social worker may be able to connect you with a support group. You may also find a support group through the Acoustic Neuroma Association.

Preparing for your appointment

You may see your family doctor or a general practitioner first. Your doctor may then refer you to a doctor who is trained in ear, nose, and throat conditions or a doctor who is trained in brain and nervous system surgery (neurosurgeon).

Be ready for your appointment by knowing what to expect. This information will help you feel more prepared and comfortable during your appointment.

What you can do

  • When you experience symptoms, write them down. This will help you remember what is happening and to track your progress.You should bring any materials that may seem related to the reason for which you scheduled the appointment, even if they are not specifically mentioned on the appointment sheet.

  • Make a list of all medications,What vitamins or supplements are you taking?

  • Invite a family member or friend to join you in your project.If possible, bring someone with you during your appointment. Sometimes it is hard to remember all the information that is provided during an appointment, so another person can help you remember.

  • Write down questions to ask your doctor.

Preparing a list of questions will help you have the most productive visit with your doctor. Some basic questions to ask your doctor about acoustic neuroma may include:

  • What is likely causing my symptoms?

  • What else could be causing my symptoms?

  • What kinds of tests do I need?

  • What treatment options are available?

  • Which one do you recommend for me?

  • What are the chances of side effects from each treatment option?

  • What happens if I do nothing?

  • Can I take any printed materials home with me? What websites do you think I should visit?

Do not hesitate to ask questions during your appointment. You can also prepare questions to ask your doctor.

What you can expect from your doctor

Your doctor may ask you a number of questions. Being prepared to answer them may allow time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you start to experience symptoms?

  • Have your symptoms been continuous or occasional?

  • How severe are your symptoms?

  • Do you have any family members with an acoustic neuroma?

  • At its current level, do you feel the hearing in the affected ear is useful to you in any way? For example, can you use that ear on the telephone, or does that ear help you tell where sound is coming from?

  • Do you have regular headaches currently or have you had them in the past?

General summary

  1. symptoms Acoustic neuroma symptoms usually indicate that the tumor is benign (noncancerous) but this isn't always the case When an acoustic neuroma becomes malignant — or cancerous — it's called a vestibular schwannoma Signs and symptoms of malignant tumors include: Hearing loss Tinnitus or ringing in the ear which may worsen with time Loss of balance particularly when turning your head to one side Numbness or weakness in the face and/or limbs on one side of your body Changes in vision including double vision or blurred vision.

  2. An acoustic neuroma is a noncancerous tumor that develops on the eighth cranial nerve, also known as the auditory nerve. This tumor is usually benign, meaning it won’t spread to other parts of the body, but can cause complications if it grows larger. Acoustic neuromas can cause hearing loss, balance problems, and facial numbness or weakness. In some cases, the tumor can be surgically removed if it’s causing any issues.

  3. Acoustic Neuroma, also known as a vestibular schwannoma, is a non-cancerous tumor that grows on the vestibulocochlear nerve. This nerve connects the inner ear to the brain, and a tumor on this nerve can cause hearing loss, ringing in the ears, and balance problems. In rare cases, acoustic neuroma can be life-threatening when the tumor compresses structures in the brain or causes increased intracranial pressure. Treatment depends on the size of the tumor and can include surgery, radiation therapy or observation.

  4. Acoustic Neuroma is a type of non-cancerous brain tumor that grows on the nerve that connects the ear to the brain. It is often referred to as an acoustic neurilemoma, vestibular schwannoma, or neurinoma. It typically affects only one ear and can cause hearing loss, balance problems, and other hearing-related issues. This condition is usually benign, but if left untreated can cause serious medical problems including facial nerve paralysis and vision loss.

Acoustic neuroma : Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors  , Complications , Prevention

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