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Acoustic neuroma (Vestibular schwannoma): Treatment, symptoms, advice and help

About acoustic neuroma (Vestibular schwannoma)

Acoustic Neuroma is a tumour of the vestibulocochlear nerve which arises from the brain and goes to the ear. The tumour is slow-growing and benign in nature.

Acoustic neuroma (Vestibular schwannoma): Incidence, age and sex

Acoustic Neuroma is an uncommon disease afflicting almost 1 person in 100,000. It is usually seen in people aged 30 to 60 years. Its incidence is more in females than males. Acoustic neuroma is rarely seen in children.

Causes and prevention of acoustic neuroma (Vestibular schwannoma)

It is a tumour which arises from the covering of the vestibulocochlear nerve. This is the eighth cranial nerve and it is responsible for hearing and balance. In a majority of cases, it has no underlying cause. It occurs spontaneously during middle age and grows slowly. But in a small percentage of people it may be genetic in nature. Acoustic neuroma can be a part of a disorder called Neurofibromatosis type 2, which is an inherited disorder afflicting the nerves of the body.

Signs and symptoms acoustic neuroma (Vestibular schwannoma): Diagnosis

The main clinical features of acoustic neuroma are hearing loss and ringing sensation(tinnitus) in one ear - the most prominent symptoms of the tumour. These features are accompanied by the loss of balance and/or vertigo.

Other clinical features may include difficulty in closing the eyelid, drooling of saliva, loss of taste sensation on one side of the tongue. The patient may be unable to smile, blink or even wrinkle his or her forehead. Such features are due to compression of another nerve called the facial nerve by acoustic neuroma. Very large tumours may press upon the brainstem (lower part of the brain), causing headache and visual impairment.

Acoustic neuroma (Vestibular schwannoma): Complications

The most dreaded complication of acoustic neuroma is the collection of fluid inside the head, also called ‘hydrocephalus’. This is seen in cases of extremely large sized tumours. This is a life-threatening condition which requires immediate medical attention.

Acoustic neuroma (Vestibular schwannoma): Treatment

The diagnosis of acoustic neuroma can be confirmed by hearing tests and imaging modalities like the MRI and CT scans. It is advisable to take the collaborative opinions of a neurologist, an audiologist, an ENT surgeon and an oncologist - together to decide the treatment of acoustic neuroma.

Apart from regular monitoring of the tumour, the key treatment modalities are radiation and surgery. The tumour can be effectively removed by surgical resection. Radiotherapy can be used to shrink tumour preoperatively and also as a follow-up treatment post-operatively. There are two types of radiation modalities available, namely stereotactic radiotherapy and stereotactic radio surgery. Both these modalities differ in their dose intensity. The treatment should be ideally decided upon, after discussion between the doctor and the patient. It also may depend upon the health status and the age of the patient.