Although advanced screening methods have made detection easier, acoustic neuroma is still a relatively rare condition affecting only 3.5 out of 100,000 individuals. Persons with this condition are typically between ages 30 and 60. Ninety-five percent of cases occur in individuals with no family history of this condition.
In this article, we will provide you with a comprehensive overview of symptoms, causes, and treatment of acoustic neuroma. After reading this piece, you will have enough knowledge to formulate important questions for your doctor and other medical personnel.
What Is an Acoustic Neuroma?
An acoustic neuroma (also known as a schwannoma) is a non-cancerous growth occurring on the eighth cranial nerve. Most commonly, acoustic neuromas occur during the fourth and fifth decade of life. The body’s twelve pairs of cranial nerves emerge from the brain and control important functions primarily in the upper body, such as swallowing or vision.
Traveling from the brain to the inner ear, the eighth cranial nerve pair governs hearing and balance. As these growths expand slowly over the years, they can possibly press on brain tissue and neighboring cranial nerves, such as those that control the facial muscles.
Even though most acoustic neuromas are smaller than an inch and don’t typically impact neighboring structures much, they can cause rather distressing symptoms due to their location on the eighth cranial nerve.
The most common symptom of these slow-growing tumors is the gradual hearing loss in one ear. Some individuals also report balance difficulties, a feeling of fullness in the ear or tinnitus, ringing in the ears. A facial paralysis, as seen in Bell’s Palsy, may be present.
No definite cause for this condition has been discovered. Recent research has linked it to a defect in the genes that prevent cells from forming tumors. Other currently popular theories include prolonged exposure to loud noise, radiation exposure, and mobile or cordless phone use.
Quickcare or ER?
Although an early acoustic neuroma has few symptoms, as the growth expands it can impinge on surrounding brain tissue, possibly causing damage. Symptoms of this compression include:
- Change in gait
These warrant an immediate trip to the Emergency Room.
Diagnosing Acoustic Neuroma
Advances in medical imaging combined with careful examination and interviewing have made it possible to accurately identify acoustic neuromas earlier than ever.
What Will Your Doctor Ask?
As during any medical interview, your doctor will want to know what your symptoms are and how long you’ve had them. He or she will ask you if anything triggers your symptoms, makes them worse or provides you with relief. Providing as many details as possible will help your doctor paint an accurate clinical portrait.
What Will Your Doctor Look for?
Since one of the earliest symptoms of acoustic neuroma is hearing loss, your doctor will most likely refer you to an audiologist for an audiogram. If the audiogram reveals hearing loss in one ear, you will be scheduled for magnetic resonance imaging (MRI) with contrast medium. The contrast medium is a medication that makes the acoustic neuroma more visible on the MRI. Since an MRI can detect very small masses, it is the gold standard for confirming a diagnosis.
What Is Your Doctor Thinking?
Since this is such a slow-growing type of tumor, your doctor is continually evaluating its impact on your health when considering possible treatment options. If the tumor is very small, he or she may choose to do nothing. A “wait and see approach” is a viable treatment option. You should consider it especially if you have any conditions that place you at increased risk from surgery or radiation. As we mentioned before, these are the two most popular treatment options.
“Wait and see” may also be a temporary treatment option; if your symptoms become intolerable or you develop issues, such as problems with balance, due to the tumor, your doctor can always re-evaluate and amend your treatment plan.
What Is the Treatment for Acoustic Neuroma
The two main treatment options for acoustic neuroma are microsurgery and radiation.
Microsurgery involves removing all or part of the acoustic neuroma. During this procedure, a portion of the skull is opened to access and remove the tumor. The amount of the tumor removed and the portion of the skull opened to access it depend on treatment goals. Some surgical approaches tend to preserve hearing better than others. If you have a larger tumor, you might loose your hearing in an irreparable way.
Hearing loss in the treated ear, ringing in the ears, fatigue, depression, dry mouth, taste alterations, and dizziness are some of the risks associated with microsurgery. Serious complications such as loss of muscle control, paralysis and death occur in less than 1% of microsurgeries for large tumors.
If you have a small or medium sized tumor, your doctor may prescribe radiation without or following microsurgery. This is most frequently accomplished using a “Gamma Knife” or “Cyber-Knife” machine and involves beaming one or more doses of radiation over the tumor. The specialist will not make any incisions.
Radiation is fast, relatively pain-free, and allows a quick return to normal activities. Some risks associated with radiation include hearing loss in the treated ear, ringing in the ears, fatigue, depression, dizziness, brain swelling and facial nerve weakness or paralysis. Before choosing a treatment option, carefully consider each one with the assistance of your doctor in light of your health goals.
How Long Will You Have Acoustic Neuroma?
Once an acoustic neuroma is removed, it is cured. Periodic MRIs are performed since tumors can sometimes reoccur. Some individuals experience problems related to the tumor long after it has been removed. In some cases, these become lifelong issues. Some common residual problems stemming from acoustic neuroma include hearing loss in the treated ear, ringing in the ears, dizziness, balance issues, facial weakness, headaches, and dry eyes.
Acoustic neuroma is a slow-growing, non-cancerous growth. Doctors can reduce, remove or destroy it through microsurgery or radiation. Treatment choice depends on the patient’s overall health, symptoms, and personal health goals. If you suspect you have an acoustic neuroma, you should seek medical assistance from a qualified provider.