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What is acoustic neuroma?

An acoustic neuroma, also called a vestibular schwannoma, is a noncancerous growth or tumor on the auditory nerve near the inner ear. The auditory nerve carries sound impulses from the ear to the brain. 

An acoustic neuroma grows slowly and can cause hearing loss in the affected ear. Although the growth is not cancerous, it can press on other nerves or brain tissues as it grows.

Our approach

Acoustic neuroma requires an accurate diagnosis and expert treatment. At Northwell Health Cancer Institute, our subspecialized radiologists and pathologists interpret all scans and tests and work closely with our cancer specialists, including board certified neuroradiologists and neuropathologists, to provide an accurate diagnosis.Your dedicated team will collaborate to achieve the best possible outcome and create a unique care plan specifically for you, including meeting regularly to review your condition and determine the progress of your treatment. Because your convenience is a primary focus, every effort is made to provide services in one location.

Symptoms

Common symptoms of acoustic neuroma include:

  • Difficulty swallowing
  • Impaired eye movement
  • One-sided hearing loss and buzzing or ringing in the ear
  • Taste disturbances
  • Unsteadiness
  • Dizziness, although less common

If the tumor affects the seventh cranial nerve, facial paralysis may also occur.

Causes

There are two types of acoustic neuromas, each with a unique cause:

  • Unilateral acoustic neuroma - This type affects only one ear. This tumor may develop at any age, but usually occurs between the ages of 30 and 60. Acoustic neuroma may be the result of gene damage caused by environmental factors, although no one environmental factor has been scientifically proven to cause it.
  • Bilateral acoustic neuromas - This type affects both ears and is hereditary, caused by a genetic disorder called neurofibromatosis-2.

Risk factors

The only known risk factor for acoustic neuroma is having a parent with neurofibromatosis-2. Genetics research scientists are learning more about mutations in genes linked to conditions like acoustic neuroma, leading to improved genetic testing procedures to detect inherited factors and gene mutations. Learn more about genetic counseling at Northwell Health.

Diagnosis

Because symptoms of acoustic neuromas resemble other middle and inner ear conditions, they may be difficult to diagnose. Preliminary diagnostic procedures include an ear examination and a hearing test. Computerized tomography (CT scan) and magnetic resonance imaging scans (MRI) help to determine the location and size of the tumor. 

Treatment types

Acoustic neuroma is most successfully treated when it's diagnosed early. There are three options for managing it: 

  • Surgical removal - Surgery is the most common treatment for acoustic neuroma and is often combined with stereotactic radiosurgery. The type of surgical procedure recommended depends on the size of the tumor and the impact that the tumor has on hearing. As a tumor grows larger, surgical removal is more complicated because of the potential for damaging surrounding nerves that control facial movement, hearing and balance. 
  • Stereotactic radiosurgery– Single focused radiation treatment is a noninvasive treatment done on an outpatient basis. The most accurate tool for this is Gamma Knife, a device with a fifty-year track record. Despite the name, there is no incision or actual surgery involved in this treatment.  
  • Observation – Many patients who are newly diagnosed with small tumors and minimal symptoms can be monitored. In many cases, the tumor doesn’t grow after the initial diagnosis.
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