Acoustic Neuroma Disease: Causes, Diagnosis, Treatment, Prevention

Health and Medicine | Nov 22, 2013


Definition

An acoustic neuroma is a benign, slow-growing tumour (‘vestibular schwannoma’ and ‘neurinoma)’. It originates in the canal connecting the brain to the inner ear. It begins in the cells. It lines one of the two nerves that make up the eighth cranial nerve. These cells are known as ‘Schwann cells’ that multiply out of control and forms a tumour. Larger tumours may involve the brain stem. Bilateral acoustic neuromas can occur in a hereditary disease called neurofibromatosis 2.

 

Causes

There are two types of acoustic neuroma. A sporadic form associated with a syndrome called neurofibromatosis type II (NF2). It is an inherited disorder. It is characterized by the growth of noncancerous tumors in the nervous system. Acoustic neuromas are the most common of these tumors.

NF2 is a rare disorder. It accounts for only 5% of acoustic neuromas. This means the vast majority are the sporadic form. Doctors aren't certain what cause the sporadic form. One known risk factor for this is exposure to high doses of radiation.

A small acoustic neuroma causes:

  • hearing – causing hearing loss or tinnitus

  • balance – causing vertigo, the sensation that you are spinning

A large acoustic neuroma can cause:

  • headaches with blurred vision

  • numbness or pain on one side of the face

  • problems with limb coordination

  • less often, muscle weakness on one side of the face 

  • in rare cases, changes to the voice or difficulty swallowing

 

Symptoms

 

The early symptoms of an acoustic neuroma are often subtle. The first symptom of acoustic neuroma is a gradual loss of hearing in one ear. Other symptoms, which may include:

  • Problems with balance

  • Vertigo

  • Facial numbness, tingling, and weakness

  • Taste changes

  • Difficulty swallowing and hoarseness

  • Headaches

  • Clumsiness or unsteadiness, and Confusion

 

 

How common are acoustic neuromas?

Acoustic neuromas are rare. Brain tumours are rare in it. It can be benign (noncancerous) or malignant (cancerous). This are divided into two main groups:

  • Primary brain tumours originate in the brain. It is a primary brain tumour.

  • Secondary brain tumours are tumours in the brain. These are malignant tumours.
    Acoustic neuromas seem to be more common in women than men.

 

 

Diagnosis

Acoustic neuromas can be difficult to diagnose. The best test to diagnose an acoustic neuroma is MRI (a magnetic resonance imaging) scan of the brain. An MRI scanner uses a powerful magnetic field and radio waves. It takes a picture of brain. It is a painless and non-invasive test. It does not use radiation. After an MRI scans; you can go back to your normal diet, activity, and medications.

 

Treatments

There are three main courses of treatment for acoustic neuroma:

  • Observation

  • Surgery

  • Radiation therapy

Surgery for acoustic neuromas may involve removing all or parts of the tumor.

Main surgical approaches for removing an acoustic neuroma are:

  • Translabyrinthine,

  • Retrosigmoid/sub-occipital

  • Middle fossa,

Possible complications due to treatments for acoustic neuroma include:

  • Damage to the facial nerve, causing facial nerve palsy.

  • Damage to the vestibulocochlear nerve, leading to deafness.

  • Damage to the trigeminal nerve, leading to facial numbness   

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