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Acoustic Neuroma

Description

Acoustic Neuroma, also known as vestibular schwannoma, is a benign (local) tumor that develops on the auditory (cochlear) and hearing, and balance (vestibular) nerves. These nerves are involved in the hearing and balance functions of the body. The tumor may lead to hearing loss and/or imbalance.

Causes

There is no exact cause for Acoustic Neuroma. According to studies, a gene present on chromosome 22, which codes for a tumor suppresser protein, undergoes mutation (change) and allows tumor formation.

The gene may be mutated due to genetic causes or external factors, such as exposure to carcinogens and mutagens. This gene mutation also occurs in neurofibromatosis type 2, a rare type of tumor.

There are other causes that have shown a correlation, however, the linkage is unclear. They can include:

  • Excessive exposure to cellphones
  • Parathyroid adenoma
  • History of radiation therapy, especially on head and neck region
  • Persistent listening of loud noises, particularly through headphones
  • Diet
Risk factors

The following are the risk factors:

  • Family history
  • Exposure to carcinogens and mutagens
  • Frequent contact with radiation, such as X-rays
Symptoms

The following are the symptoms:

  • Hearing loss, may be gradual or sudden occurring on one side or both. May be pronounced in one side
  • Tinnitus (ringing in the ears)
  • Unsteadiness and loss of balance
  • Unsteady gait
  • Dizziness
  • Facial numbness
  • Loss of muscle control (rare)
Diagnosis

Diagnosis is broadly divided into two groups:

1. Imaging:

  • The ideal diagnostic test is a Gadolinium enhanced MRI
  • If MRI is unavailable, CT scan is an alternate choice

2. Audiometry or hearing analysis:

  • This involves a series of hearing tests carried out by an audiologist to ensure hearing ability in both ears

Because the course of the disease is gradual, signs of acoustic neuroma are not evident until the disease has progressed. This is what makes acoustic neuroma difficult to diagnose. Therefore, the diagnosis revolves around the history given by the patient, and common symptoms such as difficulty in hearing.

Management

Management of acoustic neuroma is divided into four categories, depending on the severity of the tumor.

1. Observation:

If the tumor is very large in size, the doctor will only monitor the signs and symptoms to check the course of the disease. Regular imaging and follow up appointments might be needed over the course of six to twelve months.

2. Surgery:

If the tumor has grown to a considerable size, a surgical removal might be the choice of treatment. However, several other factors are needed to be kept in consideration to decide whether a person is a suitable candidate for surgery (for example age, size of the tumor, prognosis, etc.)

3. Radiotherapy:

This mode of treatment is recommended for small tumors, and for patients who cannot undergo surgery due to health risks.

4. Supportive or palliative treatment:

This is done to treat the symptoms that come along with disease, for example dizziness and hearing difficulties.

When to consult a doctor?

Early diagnosis can lead to effective and successful treatment. If your symptoms do not improve within a few days, or you experience any of the symptoms mentioned above, such as one-sided-hearing loss or trouble keeping balance, please see a doctor.

Available Medicine for Acoustic Neuroma

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