Introduction
Acoustic neuroma is also called a vestibular schwannoma. It is a tumor that grows slowly, also called benign, that is non-cancerous and affects the nerve which connects the inner ear to the brain. This nerve is responsible for balancing the body and hearing. Hence, the tumor compressing this nerve can lead to hearing loss, unsteadiness, and ringing noise in the ear.
What Are The Symptoms?
The signs and symptoms of this condition develop in long duration and can be missed easily. The main reason behind developing the symptoms is the compression of the nerve due to this tumor.
Following signs and symptoms may be noticed:
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Loss of hearing. This can worsen with time and may take up to months or years. Although in rare cases, the effect can be seen on one side or one side may be severely affected and can happen suddenly.
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Hearing ringing or tinnitus in the ear that is affected.
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Dizziness or vertigo.
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Unsteadiness and loss of balance.
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Numbness in the face area.
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Muscle weakness.
In very few cases, the brain stem can get compressed and it can lead to life-threatening conditions.
How Is It Caused?
The main causative factor of acoustic neuromas can be associated with the defect in the gene on chromosome 22. The function of this gene in the body is to produce tumor suppressor protein which helps in controlling the growth of Schwann cells that cover the nerves. No established cause is there for this defect with the gene in literature. Most of the cases are idiopathic. Also, this gene is known to show association with neurofibromatosis type 2 as an inherited defect. Neurofibromatosis type 2 is a rare condition that also involves the development of tumor cells on the nerves related to hearing and balancing the body on both sides of the head and this is called bilateral vestibular schwannomas.
Are There Any Risk factors?
Yes, certain conditions can lead to the development of schwannoma. One such condition is neurofibromatosis type 2. If the parent has this rare genetic disorder, they can inherit it in their children.
Are There Any Complications?
If not managed on time, this condition can lead to certain complications and can be permanent. They are as follows:
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Hearing loss.
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Numbness in the face.
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Weakness of muscles.
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Balancing difficulty.
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Ringing noise or sensation in the ear.
If the tumors are large, they can compress the brain stem, and thus, the fluid transportation between the brain and spinal cord is hindered, ultimately causing fluid accumulation within the skull. This can cause increased pressure within the skull.
How Can It Be Diagnosed?
As mentioned earlier, the diagnosis of this condition is often missed as the signs and symptoms develop in later stages. Many middle and inner ear problems may also depict the same signs and symptoms.
When you visit your physician, you will be asked about your signs and symptoms, family history, your other medical conditions followed by a physical examination in which the ear examination will be the main focus. Also, the following tests may be required.
Hearing Test
It is also called audiometry. A hearing specialist, known as an audiologist will conduct this test in which you will be hearing sounds that are directed to one ear at one point of a given time. Various ranges of sound are produced in the ear to check for your hearing. Also, the lowest faint sound that you can hear is noted. Also, certain words can be pronounced or whispered to check your hearing capability.
Imaging Test
Magnetic resonance imaging (MRI) with contrast dye is the commonly used imaging test to diagnose acoustic neuroma. This test can help in identifying even the smallest tumors that measure 1 to 2 millimeters in diameter. Another option is computed tomography or CT (computed tomography) scans but the disadvantage is that the smallest tumors can be missed in them.
How Can It Be Treated?
The management of acoustic neuroma depends on the size and location of the tumor, the overall general health of the patient, and the severity of the symptoms being experienced by the patients.
The main three options available to manage this condition based on the above factors are monitoring, surgery, or radiation therapy.
Monitoring
If the neuroma is small and is not growing or showing any signs and symptoms, the physician may decide to monitor it. In this, regular 6 months to 1-year follow-up is advised including hearing tests and imaging tests.
Surgery
Surgical removal of the tumor is advised if the tumor is growing continuously, large in size, and is associated with signs and symptoms. A neurosurgeon does the procedure. The surgery is done under general anesthesia. Certain complications can occur post-surgery if the nerves in the associated areas are irritated or damaged and thus can cause the symptoms of hearing loss on one side and balancing can get affected. Anyway, balancing is affected temporarily but the hearing loss can occur permanently.
Radiation Therapy
Various radiotherapy types can be utilized in managing this condition which includes the following:
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Stereotactic radiosurgery. This is done in small tumors.
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Stereotactic radiotherapy. This is used to stop the growth of the tumor without damaging the surrounding brain tissue.
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Proton beam therapy. In this, high energy protons are utilized in targeted doses and thus, minimizing excessive exposure to the surrounding area.
Supportive Therapy
This therapy focuses on helping patients in managing the complications like balancing issues or dizziness issues, hearing loss, etc. Cochlear implants or other management strategies can be utilized to manage hearing loss.
Conclusion
Acoustic neuroma is a benign condition wherein the vestibular nerve is affected, The tumor grows and leads to compression of the nerve leading to various signs and symptoms, and finally, if left untreated, can lead to certain complications. You can know more about this condition by consulting a specialist online through online medical platforms.
