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Acoustic Neuroma

Overview

Acoustic neuromas, also known as vestibular schwannomas, are benign (non-cancerous) tumours that develop from the Schwann cells, responsible for insulating the eighth cranial nerve (vestibulocochlear nerve). This nerve is important for hearing and balance. Acoustic neuromas rarely turn malignant, but they can cause symptoms by pressing on nearby nerves or brain structures.

  • Unilateral (one-sided): Most common, usually occurs sporadically without a family history.
  • Bilateral (both sides): Rare, often associated with a genetic condition called Neurofibromatosis type 2 (NF2).

The symptoms usually develop gradually but can worsen over time. Common symptoms include:

  • Hearing loss (usually one-sided and affecting higher sound frequencies first)
  • Ringing in the ear (tinnitus)
  • Balance problems or giddiness
  • Imbalance while walking
  • Facial weakness or numbness
  • Headache, nausea, or vomiting (if the tumour is large or is blocking fluid circulation in the brain)

The exact cause is often unknown. However, the following risk factors are involved:

  • Genetic risk factor: A family history of the rare genetic condition neurofibromatosis type 2 significantly increases the risk.
  • Environmental risk factor: Exposure to radiation, particularly to the head, has been conclusively associated with a higher risk of acoustic neuroma. 

To confirm diagnosis, doctors may recommend:

  • Audiogram (hearing test): For high-frequency hearing loss
  • CT scan: For contrast-enhancing lesion with widening of the ear canal
  • MRI brain: Most accurate test, showing the classic “ice-cream cone appearance” in the inner ear region

Treatment depends on tumour size, symptoms, and overall health:

  • Observation/Monitoring: Usually, conservative treatment is required with monitoring through regular MRI scans.
  • Microsurgery (removal of tumour): Expanding or large lesions may be excised (through the suboccipital, translabyrinthine, or middle fossa approach). Surgery carries the risk of hearing loss, facial nerve injury, or vertigo.
  • Stereotactic radiotherapy (focused radiation): A non-invasive option for smaller tumours. It has a lower morbidity risk than in surgery.

Consult a doctor if you notice:

  • Sudden or progressive hearing loss in one ear
  • Persistent ringing in one ear
  • Trouble maintaining balance
  • Unexplained facial weakness

There are no proven ways to prevent acoustic neuroma. However:

  • Early diagnosis in people with family history of NF2 can help with timely treatment.
  • Avoid unnecessary radiation exposure to the head and neck whenever possible.

If you suspect an acoustic neuroma, you may be referred to a Neurologist (for initial evaluation and diagnosis) or Neurosurgeon (for surgery, if needed).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.