Management Team

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). Acoustic neuromas rarely turn malignant.

Acoustic neuromas may occur suddenly. Bilateral occurrence may be associated with Neurofibromatosis type 2, which is a genetic disorder.

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 the head, has been conclusively associated with a higher risk of acoustic neuroma. However, there is currently no evidence suggesting a link between the use of cell phones and the development of these tumours.

  • Hearing loss on the side of the lesion
  • Ringing in the ear (Tinnitus)
  • Giddiness
  • Imbalance on walking
  • Facial weakness
  • Headache, nausea, or vomiting, if the tumour is large or is compressing the ventricular outflow system.

Neurologist/ Neurosurgeon

  • Audiogram- For high frequency hearing loss
  • CT scan- For contrast enhancing lesion with expansion of internal auditory canal
  • MRI brain- For detecting ice cream cone appearance in posterior fossa

  • Usually, conservative treatment is required with monitoring through serial MRI
  • Expanding or large lesions may be excised (through suboccipital or translabyrinthine or middle fossa approach)
  • Excision carries the risk of morbidities  such as hearing loss, facial nerve injury or vertigo
  • Stereotactic radiotherapy has low morbidity risk compared with surgery
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