How can acoustic neuroma impact your health?

An acoustic neuroma is a benign tumour that can cause hearing loss, imbalance, or even facial numbness, and can greatly impact a person’s quality of life. Although relatively rare, acoustic neuromas are important to diagnose and manage early to prevent complications.

Leading ENT specialist Mr Peter Monskfield covers what acoustic neuroma is, what causes it, how it is diagnosed, and the treatment options available for those affected.

What is an acoustic neuroma?

An acoustic neuroma, or vestibular schwannoma, is a benign tumour that forms on the vestibulocochlear nerve. This nerve is essential for hearing and balance, as it transmits signals from the inner ear to the brain. Acoustic neuromas grow slowly, but as they enlarge, they can press against surrounding brain structures, leading to various symptoms. Although acoustic neuromas are benign, meaning they do not spread to other parts of the body, they can still cause significant health issues if left untreated.

What are the symptoms of an acoustic neuroma?

Symptoms of an acoustic neuroma can vary, depending largely on the size and location of the tumour. Early symptoms are often subtle and may include hearing loss, usually in one ear, along with a persistent ringing or buzzing sound known as tinnitus. Individuals may also experience a feeling of imbalance or unsteadiness, particularly when moving their head. In some cases, people report dizziness or vertigo, a sensation of spinning.

As the tumour grows, it may begin to exert pressure on nearby nerves, including those that control facial muscles and sensations. This can lead to numbness or tingling in the face, or even facial weakness. In rare, advanced cases, large acoustic neuromas can put pressure on the brainstem and surrounding structures, which may impact life-sustaining functions such as breathing and heart rate.

What causes an acoustic neuroma?

The exact cause of acoustic neuroma is not entirely understood. However, it is believed that most cases occur sporadically, without a specific genetic or environmental cause. In some instances, a genetic condition called neurofibromatosis type II (NF2) may be responsible. NF2 is a rare inherited disorder that can lead to multiple tumours on nerves throughout the body, including acoustic neuromas on both sides.

How is an acoustic neuroma diagnosed?

If acoustic neuroma is suspected, a thorough examination by an ear, nose, and throat specialist (ENT) or a neurotologist is essential. The diagnostic process usually includes hearing tests, called audiometry, which assess the extent of hearing loss. Imaging studies, such as magnetic resonance imaging (MRI), are crucial for confirming the presence of an acoustic neuroma, as they provide detailed images of the brain and inner ear structures.

What are the treatment options for acoustic neuroma?

Treatment depends on the size and growth rate of the tumour, as well as the patient’s overall health and symptoms. In cases where the tumour is small and causing minimal symptoms, doctors may recommend regular monitoring through periodic MRI scans, a practice known as "watchful waiting." For larger tumours or those causing significant symptoms, treatments may include radiation therapy to slow or stop the tumour’s growth or, in some cases, surgical removal. Surgery can be complex due to the tumour’s proximity to nerves involved in hearing, balance, and facial movement, but it may be necessary for tumours affecting quality of life or causing life-threatening complications.

Each treatment has its potential risks and benefits, and a medical professional will help patients decide on the best approach based on individual circumstances.

If you would like to book a consultation with Mr Monksfield, simply visit his Top Doctors profile today.