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An acoustic neuroma is a slow-growing tumor of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve. It is behind the ear right under the brain.
An acoustic neuroma is not cancerous (benign). This means that it does not spread to other parts of the body. However, it can damage several important nerves as it grows.
Vestibular schwannoma; Tumor - acoustic; Cerebellopontine angle tumor; Angle tumor
Acoustic neuromas have been linked with the genetic disorder neurofibromatosis type 2 (NF2).
Acoustic neuromas are uncommon.
The symptoms vary based on the size and location of the tumor. Because the tumor grows so slowly, symptoms most often start after age 30.
Common symptoms include:
Less common symptoms include:
The health care provider may suspect an acoustic neuroma based on your medical history, an exam of your nervous system, or tests.
Often, the physical exam is normal when the tumor is diagnosed. Sometimes, the following signs may be present:
The most useful test to identify an acoustic neuroma is an MRI of the brain. Other tests to diagnose the tumor and tell it apart from other causes of dizziness or vertigo include:
Treatment depends on the size and location of the tumor, your age, and your overall health. You and your health care provider must decide whether to watch the tumor (observation), use radiation to stop it from growing, or try to remove it.
Many acoustic neuromas are small and grow very slowly. Small tumors with few or no symptoms may be watched for changes, especially in older patients. Regular MRI scans will be done.
If they are not treated, some acoustic neuromas can damage the nerves involved in hearing and balance. They can also affect the nerves responsible for movement and feeling in the face. Very large tumors can lead to a buildup of fluid (hydrocephalus) in the brain, which can be life threatening.
Removing an acoustic neuroma is more commonly done for:
Surgery is done to remove the tumor and prevent other nerve damage. Any hearing that is left is often lost with surgery.
Stereotactic radiosurgery focuses high-powered x-rays on a small area. It is considered to be a form of radiation therapy, not a surgical procedure. It may be used:
Removing an acoustic neuroma can damage nerves, which may cause loss of hearing or weakness in the face muscles. This damage is more likely to occur when the tumor is large.
An acoustic neuroma is not cancer. The tumor does not spread (metastasize) to other parts of the body. However, it may continue to grow and press on structures in the skull.
People with small, slow-growing tumors may not need treatment.
Once hearing loss occurs, it does not return after surgery or radiosurgery.
Call your health care provider if you have:
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Sweeney P, Yajnik S, Hartsell W, Bovis G, Venkatesan J. Stereotactic radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am. 2009;42:655-663.
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