Because symptoms of acoustic neuromas often mimic other middle and inner ear conditions, diagnosis can be difficult. Doctors will usually start with an ear examination and hearing test and then order imaging scans of the head, such as a CT or MRI scan.
Symptoms most commonly relate to cranial nerve eight, which controls hearing and balance, but can also involve CN 7 (facial strength and function) and CN 5 (trigeminal neuralgia). These include tinnitus and unsteadiness or loss of balance.
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This is the most common symptom of an acoustic neuroma and usually occurs in one ear. It can cause difficulty hearing in noisy places, and a sense that the room is spinning (vertigo). If you have this symptom, contact your doctor or an otolaryngologist. They can diagnose your acoustic neuroma with a gadolinium-enhanced MRI scan.
A ringing or buzzing sound in the ears is also a common sign of an acoustic neuroma, and is called tinnitus. The noise may get worse as the acoustic neuroma grows and presses on more nerves in the head and neck.
Other symptoms of a growing acoustic neuroma include loss of balance and changes in how your body moves. If the acoustic neuroma presses on the nerve that controls your facial movement, you may notice problems with smiling or keeping food in your mouth while you eat. The same pressure on this nerve can affect how your eyes move and how you produce tears.
If the acoustic neuroma starts to press against your brain stem or cerebellum, it can cause headaches. This can be due to a buildup of fluid or from the pressure of the tumor itself. If you have this symptom, visit your doctor as soon as possible. They will help you decide whether you need further tests or treatment.
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Symptoms of an Acoustic Neuroma are usually one-sided (unilateral). It is very common for people with these tumors to experience a gradual loss of hearing in only one ear. This can happen slowly over time, or in some cases more quickly. It can also be accompanied by dizziness, balance problems and ringing in the ear.
These tumors are slow-growing and benign, but they can still be life-threatening if left untreated. When they grow too large, they can press on the brain stem, causing a build-up of cerebral spinal fluid and squashing important vital functions like breathing, blood pressure and heart rate. In rare, untreated cases, these tumors can also cause numbness or paralysis in the face.
Diagnostic tests include magnetic resonance imaging (MRI) scans, which provide detailed images of your head and can reveal the size and location of an acoustic neuroma. Computerized tomography (CT) scans may also be used to help in the diagnosis.
The Siteman team specializes in surgically removing acoustic neuromas, with an emphasis on preserving the patient’s ability to hear. Our surgeons have extensive training and expertise in this delicate procedure, which is often performed using a minimally invasive approach that involves drilling into the skull through a hole drilled behind your ear. Our specialists can also offer vestibular rehabilitation therapy, which helps patients compensate for lost nerves that control balance.
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If a tumour grows until it runs out of space inside the small canal that links the inner ear to the brain, it can start to squash tissue at the base of the skull including a structure called the brain stem. This area controls vital bodily functions such as consciousness, heart rate, breathing and blood pressure. Larger acoustic neuromas can also squash nerves that control balance and movement, leading to dizziness or unsteady movements (ataxia) and headaches.
People with smaller tumors, known as intracanalicular-stage acoustic neuromas, may notice hearing loss in one ear. This usually occurs gradually, and can be accompanied by noise in the head or neck (tinnitus), or by problems with balance on the affected side. Some patients, especially those with larger tumors, can experience facial weakness or numbness. These symptoms are due to the tumour pressing against a nerve in the face called CN 8 or the trigeminal nerve.
Because the symptoms of acoustic neuroma can mimic those of other middle ear conditions, early diagnosis is important. This is best done through a thorough ear examination, hearing test and imaging such as computerized tomography (CT) or magnetic resonance imaging (MRI). A rare genetic condition called neurofibromatosis type 2 often causes growth of these tumours. It’s not clear what causes it, but the change in gene results in a growth of Schwann cells that cover nerves in the brain and inner ear.
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An acoustic neuroma, also known as a vestibular schwannoma, is a noncancerous (benign) tumor that grows from Schwann cells that normally wrap around and support nerve fibers in the inner ear. These neurons connect the inner ear with the brain. When a tumor develops, it can cause hearing loss that may get worse over time and other symptoms like vertigo or ringing in the ears. Headaches can also be a symptom of an acoustic neuroma, especially in people with a large tumor that is pushing on the cerebellum and brain stem.
These tumors are easy to miss in the early stages because symptoms are often slow to start and may not progress over months or years. During this time, doctors may recommend observation and regular MRI scans to monitor changes.
The most common symptom of acoustic neuroma is gradual hearing loss in one ear that is not the same on both sides. Sometimes the acoustic neuroma will grow into the space around the eighth cranial nerve and cause other symptoms such as vertigo or ringing in the ear.
Rarely, acoustic neuromas can grow to the point where they are pressing on other nerves, such as the facial nerve that controls sensation in the face (trigeminal neuralgia) or blood vessels and brain structures. This can lead to symptoms such as facial numbness or tingling in the face, as well as weakness of the muscles that control the eyes.