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Ear, Nose, and Throat Disorders

Acoustic Neuromas

Acoustic Tumor ShotAlthough acoustic neuromas are non-malignant (not cancerous) growths, they can cause significant problems. These tumors make up 10% of all brain tumors. These tumors are known as vestibular schwannomas. They occur deep inside the skull next to vital brain centers (brainstem, cerebellum) and affect the 8th cranial nerve (balance / hearing nerve).

Symptoms

The first symptoms usually relate to ear function and include ear noise (tinnitus), hearing loss (on the side of the tumor), and dizziness or imbalance. As the tumors enlarge, they involve the surrounding brain and affect more vital functions (including facial nerve function- the ability to move the face). Headaches may develop as a result of increased pressure on the brain. If allowed to continue over a long period of time, this pressure on the brain will result in death. In most cases, acoustic neuromas grow slowly over a period of years, but they can grow more quickly (such as when they bleed or undergo degeneration into a fluid-filled cyst).

Diagnosis

Unfortunately, a careful check of all patients with the symptoms listed above does not always result in an early diagnosis of acoustic tumors. At the minimum, patients with hearing loss and balance problems should get a hearing test and see an otolaryngologist. Depending on the findings and symptoms, an MRI scan with contrast may need to be ordered. The goal is to catch these tumors at an early stage, which increases the chance of preserving hearing, facial nerve function, and other important functions.

Treatment

The standard treatment for acoustic neuromas is surgical removal (via the middle cranial fossa, translabyrinthine, or retrosigmoid approaches). The risks of surgery are less than the risk of leaving the tumor untreated in most cases. The earlier the tumors are diagnosed and removed, the less likely the possibility of serious complications. Radiation therapy is an option for patients who are elderly or too sick to undergo surgery.

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Last Reviewed: Jan 31, 2008

Ravi N Samy, MD, FACS Ravi N Samy, MD, FACS
Assistant Professor of Otolaryngology, Director of Skull Base Surgery Fellowship, Director of Adults Cochlear Implantation Program
College of Medicine
University of Cincinnati

David  L Steward, MD David L Steward, MD
Professor of Otolaryngology
College of Medicine
University of Cincinnati