What is Acoustic Neuroma? Symptoms, Causes, & Treatment

An acoustic neuroma is a non-cancerous tumor that grows on the nerve connecting your ear to your brain. This slow-growing tumor develops on the vestibular nerve, which helps control your balance and hearing. While the name might sound scary, these tumors are benign, meaning they won't spread to other parts of your body like cancer would.

Most acoustic neuromas grow very slowly over many years. Some people live with small ones without ever knowing they're there. The tumor forms from the protective covering around your nerve, similar to how insulation covers an electrical wire.

What are the symptoms of acoustic neuroma?

The most common early sign is gradual hearing loss in one ear. You might notice sounds becoming muffled or feel like people are mumbling when they talk to you. This hearing change usually happens so slowly that many people don't realize it's occurring.

As the tumor grows, you may experience additional symptoms that can affect your daily life:

• Ringing in your ear (tinnitus) that doesn't go away
• Feeling unsteady or dizzy, especially when walking
• Fullness or pressure in your affected ear
• Difficulty understanding speech, particularly in noisy places
• Balance problems that make you feel like you're swaying

In rare cases where the tumor becomes quite large, you might experience more serious symptoms. These can include facial numbness, weakness on one side of your face, or severe headaches. Very large tumors can occasionally cause vision problems or difficulty swallowing.

The symptoms develop gradually because your brain has time to adapt to the changes. This is why many people don't seek help immediately, thinking their hearing loss is just part of getting older.

What causes acoustic neuroma?

Most acoustic neuromas develop without any clear reason. The tumor forms when cells in the nerve's protective covering start growing abnormally. Scientists believe this happens due to a genetic change in these cells, but we don't fully understand why this occurs.

The only known risk factor is a rare genetic condition called neurofibromatosis type 2 (NF2). People with NF2 have a much higher chance of developing acoustic neuromas, often in both ears. However, this condition affects fewer than 1 in 25,000 people.

Some studies have looked at whether cell phone use or loud noise exposure might increase risk, but research hasn't found a clear connection. Age does play a role, as these tumors most commonly appear in people between 40 and 60 years old.

When to see a doctor for acoustic neuroma?

You should contact your doctor if you notice hearing loss in one ear that doesn't improve. Even if the change seems minor, it's worth having it checked since early detection can lead to better treatment outcomes.

Make an appointment sooner rather than later if you experience sudden hearing loss, persistent ringing in one ear, or new balance problems. While these symptoms can have many causes, your doctor needs to rule out an acoustic neuroma and other conditions.

Seek immediate medical attention if you develop severe headaches, vision changes, or facial weakness. These symptoms might indicate a larger tumor that needs prompt evaluation and treatment.

What are the risk factors for acoustic neuroma?

Age is the main risk factor for developing an acoustic neuroma. Most people diagnosed with this condition are between 40 and 60 years old, though it can occur at any age.

Having neurofibromatosis type 2 significantly increases your risk. This genetic condition causes tumors to grow on various nerves throughout your body. If you have a family history of NF2, genetic counseling can help you understand your risk.

Previous radiation exposure to your head or neck area, particularly during childhood, may slightly increase your risk. This includes radiation treatments for other medical conditions. However, the overall risk remains very low even with this exposure.

What are the possible complications of acoustic neuroma?

The most common long-term effect is permanent hearing loss in the affected ear. This can happen gradually as the tumor grows or sometimes occurs after treatment. Many people learn to adapt well to hearing with one ear.

Balance problems can persist even after treatment, though most people's balance improves over time. Your brain learns to rely more on your other balance systems, including your vision and the balance organ in your unaffected ear.

Facial nerve problems represent a more serious but less common complication. Large tumors can affect the facial nerve that runs close to the hearing nerve. This might cause facial weakness, difficulty closing your eye, or changes in taste. The risk is higher with larger tumors or certain treatment approaches.

In very rare cases, large tumors can cause life-threatening complications by pressing on brain structures that control vital functions. This is why doctors monitor acoustic neuromas carefully and recommend treatment when appropriate.

How is acoustic neuroma diagnosed?

Your doctor will start with a hearing test to check how well each ear is working. This test can reveal the pattern of hearing loss that's typical with acoustic neuromas. You'll listen to sounds through headphones and respond when you hear them.

An MRI scan provides the definitive diagnosis. This imaging test uses magnetic fields to create detailed pictures of your brain and inner ear. The scan can show even small tumors and help your doctor plan the best treatment approach.

Your doctor might also order balance tests if you're experiencing dizziness or unsteadiness. These tests help determine how well your balance system is working and can guide treatment decisions.

Sometimes doctors find acoustic neuromas accidentally when doing MRI scans for other reasons. These incidental findings are becoming more common as imaging technology improves.

What is the treatment for acoustic neuroma?

Treatment depends on several factors, including the tumor's size, your symptoms, and your overall health. Small tumors that aren't causing significant problems might just need regular monitoring with MRI scans every 6 to 12 months.

Surgical removal is often recommended for larger tumors or those causing severe symptoms. The surgery aims to remove the entire tumor while preserving as much hearing and facial nerve function as possible. Recovery typically takes several weeks to months.

Stereotactic radiosurgery offers a non-invasive alternative to traditional surgery. This treatment uses precisely focused radiation beams to stop the tumor from growing. It's often preferred for smaller to medium-sized tumors in older patients or those who aren't good candidates for surgery.

Hearing aids can help manage hearing loss when the tumor is small or after treatment. Some people benefit from special hearing aids that transfer sound from the affected ear to the good ear.

How to manage symptoms at home during acoustic neuroma?

If you're experiencing balance problems, make your home safer by removing tripping hazards and installing grab bars in bathrooms. Good lighting helps you navigate more safely, especially at night.

For hearing difficulties, position yourself so you can see people's faces when they speak. This helps you use visual cues to understand conversation better. Ask people to speak clearly rather than loudly.

Tinnitus can be particularly bothersome at night. Background noise from a fan, white noise machine, or soft music can help mask the ringing and improve sleep quality.

Stay active with gentle exercises like walking or swimming to help maintain your balance and overall health. Avoid activities that put you at risk of falling until your balance improves.

How should you prepare for your doctor appointment?

Write down all your symptoms and when you first noticed them. Include details about your hearing changes, balance problems, and any other concerns. This information helps your doctor understand your condition better.

Bring a list of all medications you're taking, including over-the-counter drugs and supplements. Some medications can affect hearing or balance, so your doctor needs this complete picture.

Consider bringing a family member or friend to your appointment. They can help you remember important information and provide support during discussions about treatment options.

Prepare questions about your condition, treatment options, and what to expect. Don't hesitate to ask about anything you don't understand.

What's the key takeaway about acoustic neuroma?

Acoustic neuromas are non-cancerous tumors that grow slowly and can often be managed successfully with proper medical care. While they can cause concerning symptoms like hearing loss and balance problems, they're not life-threatening in most cases.

Early detection and appropriate treatment can help preserve your quality of life. Many people with acoustic neuromas continue to live normal, active lives with proper management and support.

Remember that having an acoustic neuroma doesn't mean you're in immediate danger. These tumors grow slowly, giving you and your healthcare team time to make thoughtful decisions about the best treatment approach for your specific situation.