With review and feedback from CEENTA Neurotologists Steven Gold, MD, and Brendan O’Connell, MD (SouthPark)
Hearing loss, tinnitus, and dizziness can have a number of causes. Today we would like to discuss one of those causes: the tumor known as the acoustic neuroma.
An acoustic neuroma - or vestibular schwannoma - is generally a slow-growing, benign tumor that develops on the hearing and balance nerve. The hearing and balance nerve comes off the brain stem and passes through the internal auditory canal on its way to the inner ear, where it terminates and stimulates the cochlea and the balance canals. While acoustic neuromas are typically limited to one ear, in certain genetic conditions they can occur bilaterally.
Common signs of an acoustic neuroma include sudden or gradual hearing loss, tinnitus, and dizziness. It is not common for an untreated acoustic neuroma to result in facial weakness, although this becomes relevant when considering treatment, CEENTA Neurotologist Brendan O’Connell, MD, said. The facial nerve runs immediately adjacent to the hearing and balance nerve as it leaves the brainstem and travels toward the inner ear. When an acoustic neuroma is present, the facial nerve courses along the capsule of the tumor. If a tumor becomes very large, it will eventually press against the brainstem and can potentially become life-threatening.
Most unilateral acoustic neuromas occur sporadically and are not inherited. Bilateral acoustic neuromas affect both ears and are typically associated with neurofibromatosis type 2 (NF2), which is a genetic condition.
The gold-standard for diagnosing an acoustic neuroma is an MRI scan with contrast. Doctors use the patient’s history, physical examination findings, and hearing test results to decide when an MRI should be ordered.
Treatment depends on a multitude of factors. In general, treatment options include observation with serial imaging (watch and wait), surgery, or radiation (e.g. stereotactic radiosurgery, gamma-knife, or cyber-knife). The size of the tumor, symptoms at presentation, age of the patient, hearing status, personal preference/quality of life goals, and overall medical health are important variables in deciding what treatment is best. For example, if a small acoustic neuroma is identified in an older patient who is relatively asymptomatic, they may choose to observe the tumor for growth over time. Conversely, a larger tumor resulting in brainstem compression likely warrants surgical removal.
After surgery, some patients will benefit from bone-anchored hearing devices or other technology to address any hearing loss the neuroma caused, CEENTA Neurotologist Steven Gold, MD, said. They may also need treatment for any balance or dizziness issues.
The providers at CEENTA work closely with neurosurgeons and radiation oncologists in the Charlotte area to offer the highest quality care for this condition. The CEENTA team has extensive experience with management of acoustic neuromas and strives to make a shared treatment decision with each individual patient to optimize their quality of life.
If you think you may have an acoustic neuroma, schedule an appointment at CEENTA today.
This blog is for informational purposes only. For specific medical questions, please consult your doctor. New patients can make appointments online with our ENT doctors in North and South Carolina. Current patients can also make appointments through myCEENTAchart with physicians they have already seen.
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