An acoustic neuroma is a benign tumor that develops on the nerve connecting the ear to the brain. It can lead to hearing loss, ringing in the ear, dizziness, and balance problems. Early detection allows doctors to treat it effectively and protect hearing and facial nerve function.
Why does this disease occur?
- An acoustic neuroma develops when Schwann cells covering the vestibular nerve start growing abnormally
- In some cases, this is linked to a faulty gene on chromosome 22, which normally regulates cell growth.
- Most cases have no identifiable cause.
- A small percentage of cases are inherited through a rare condition called neurofibromatosis type 2 (NF2).
- NF2 can cause tumors on the balance and hearing nerves on both sides of the head.
What are the symptoms?
Symptoms often develop gradually and may take years to appear. They result from the tumor pressing on nerves responsible for hearing, balance, and occasionally facial movement or sensation.
Common symptoms include:
- Gradual hearing loss in one ear, sometimes sudden
- Ringing or buzzing in the affected ear (tinnitus)
- Unsteadiness or difficulty maintaining balance
- Dizziness
- Facial numbness, or rarely, facial weakness
In rare cases, a large tumor may compress the brainstem and become life-threatening.
Who is at risk of this disease?
- The main risk factor is having a parent with neurofibromatosis type 2 (NF2), an inherited disorder. NF2 is autosomal dominant, meaning each child of an affected parent has a 50% chance of inheriting it. It accounts for about 5% of all acoustic neuroma cases.
- NF2 is associated with tumors on both hearing and balance nerves.
- Tumors may also develop on other nerves in people with NF2.
What complications can an acoustic neuroma cause?
- Hearing loss, which may be permanent
- Facial numbness or weakness
- Balance problems
- Tinnitus (ringing in the ear)
- In rare cases, brainstem compression may block cerebrospinal fluid flow, leading to fluid buildup in the brain
- Increase pressure inside the skull, potentially becoming life-threatening
How is this disease diagnosed?
Diagnosis begins with a physical and an ear examination. Since symptoms are similar to other ear conditions, further tests are often required:
Hearing test (audiometry): Measures tone and word recognition in each ear.
MRI with contrast: The most accurate method, detecting tumors as small as 1–2 mm.
CT scan: Used if MRI is not possible, but may miss small tumors.
What is the treatment?
Treatment depends on tumor size, growth rate, symptoms, and overall health.
Watchful Waiting
Recommended for small, slow-growing tumors with minimal or no symptoms. Regular MRIs and hearing tests every 6-12 months track tumor growth. Intervention is advised if the tumor enlarges or symptoms worsen.
Surgery
Surgery removes part or all of the tumor, especially if it is large, growing, or causing symptoms. Different approaches are used based on tumor size and hearing levels. The goal is to remove the tumor while preserving facial nerve function. Risks may include hearing loss, facial weakness, balance issues, headaches, cerebrospinal fluid leakage, meningitis, or, rarely, stroke or bleeding.
Radiation Therapy
Radiation can stop tumor growth while protecting surrounding tissue:
Stereotactic radiosurgery: Targets small tumors precisely.
Fractionated stereotactic radiotherapy (SRT): Delivers small doses over multiple sessions.
Proton beam therapy: Minimizes radiation to surrounding tissue.
Potential side effects include hearing loss, facial numbness, tinnitus, balance problems, or continued tumor growth.
Supportive therapies
- Balance rehabilitation and dizziness management
- Cochlear implants or hearing devices
How can you take care at home?
- Avoid loud noises to protect hearing
- Use assistive hearing devices if recommended
- Practice balance or vestibular exercises
- Attend all scheduled MRI and hearing test appointments
- Manage stress through counseling or support groups
How can this disease be prevented?
There is no proven way to prevent acoustic neuroma. Families with a history of NF2 should consider genetic counseling. Early detection through hearing tests and medical evaluation can prevent complications
When should you see a doctor?
Seek medical attention if experiencing:
- Hearing loss in one ear
- Ringing or buzzing in the ear
- Unexplained dizziness or balance issues
- Facial numbness
- Early diagnosis helps prevent severe hearing damage and other complications.
Frequently Asked Questions (FAQs)
Q1. Is an acoustic neuroma cancer?
No. It is a benign tumor that rarely becomes life-threatening unless it compresses the brainstem.
Q2. Will hearing be lost permanently?
Hearing loss is common and sometimes permanent, especially in large tumors or after surgery. Early detection improves the chance of preserving hearing.
Q3. How fast does the tumor grow?
Most grow slowly over the years, but some may grow rapidly and require urgent treatment.
Q4. Can both ears be affected?
Yes, but this is rare and usually linked to NF2.
Important Note: This information is for awareness only. Consult a healthcare professional for advice, diagnosis, or treatment.
