Acoustic Neuroma

Renowned Brain & Spinal Tumor Care Center

The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health is a multidisciplinary team of experts, board-certified in neurology, neurosurgery, neuro-oncology, neuro-radiologists, and other fields, such as otolaryngology. Our team collaborates to provide exceptional care for patients diagnosed with acoustic neuromas and other brain or spinal cord tumors. Our team provides comprehensive diagnostic testing and safe, effective options for treating acoustic neuroma, and we continually strive to improve our acoustic neuroma treatment by utilizing and incorporating the latest scientific findings into patient care.

If you suspect you have a brain tumor or would like a second opinion for your diagnosis, contact us today.

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What Are Acoustic Neuromas?

Also called neurinomas or vestibular schwannomas, acoustic neuromas are rare, benign (non-cancerous) tumors which primarily affect hearing and balance, because they press on the nerves in the inner ear. They usually grow slowly and are unnoticeable by those affected for years. Acoustic neuromas affect about 2,500 to 3,000 newly diagnosed people per year, nationwide, and constitute 6-10% of all brain tumors, according to the Acoustic Neuroma Association. They grow slowly from an overproduction of Schwann cells, which normally wrap around myelin nerve fibers, forming a protective sheath. When Schwann cells overproduce in the eighth cranial nerve, which connects the ear to the brain (the vestibulocochlear/acoustic nerve), a schwannoma develops.

Although these tumors are benign, they are not harmless. In fact, if the tumor is allowed to keep growing, it will press against sensitive structures and can severely affect neurological function and become life-threatening. This happens when large tumors place excessive pressure on the brainstem, putting vital, life-sustaining functions at risk.

The two types of acoustic neuromas are:

  • Unilateral acoustic neuromas: This is the most common form of acoustic neuroma, affecting 90% of those who suffer from an acoustic neuroma. It affects only one ear, and can be caused by environmental factors, such as constant exposure to loud noise, causing nerve damage. However, no environmental factor has yet been proven as the cause of acoustic neuromas.
  • Bilateral acoustic neuromas: When both ears are affected, it is said to be “bilateral.” This is caused by the genetic disorder, neurofibromatosis type 2 (NF2). NF2 is very rare and is most common in those with a genetic history.

Risk Factors for Acoustic Neuroma

Like many brain tumors, the cause of acoustic neuroma is not well understood. It is caused by a malfunctioning gene on chromosome 22, which produces tumor-suppressing proteins helping control Schwann cell growth.

Suspected risk factors for Acoustic Neuroma include:

  • Listening to constant, continuous loud noise such as music or work-related noise
  • Radiation exposure to the neck or face can cause acoustic neuromas many years later
  • A diagnosis of neurofibromatosis type 2 (NF2) puts you at a higher risk

Symptoms of Acoustic Neuromas

Symptoms vary and can range from mild hearing loss in one year to severe loss of balance, and constant dizziness. Some patients experience no symptoms if the tumor is small and slow-growing.

The primary symptoms of acoustic neuromas are:

  • Hearing loss, usually in only one ear, and a slow onset
  • Dizziness or vertigo
  • Ringing in the ear (tinnitus), reported by 80% of all patients
  • Numbness or tingling in the face
  • Problems with coordination, walking, and balance

Acoustic Neuroma Diagnosis

Your neurologist will perform a comprehensive physical exam, including examining the ears. Acoustic neuromas can be difficult to diagnose, because they have similar symptoms to other inner and middle ear conditions. Usually, the first diagnostic procedures are an ear examination and hearing test. Imaging scans of the head can determine the size and location of a suspected tumor.

  • Hearing test: Called audiometry, this test is conducted by an audiologist, who is a specialist in hearing. You will hear sounds directed to one ear then the other, with a range of sounds, and at different volumes.
  • Scans of the head: The preferred imaging test for acoustic neuroma, and most brain tumors, is magnetic resonance imaging (MRI) scans. This test can confirm the presence of an acoustic neuroma, even of the smallest sizes. A computerized tomography (CT) scan can be used if you are unable to have an MRI, but it doesn’t detect the smallest tumors.

Acoustic Neuroma Treatment

Treatment for an acoustic neuroma depends on the patient’s age, overall health, the size and location of their tumor, and how fast the tumor is growing. Some patients’ tumors are so small and symptomless, that the “wait and see” approach is the best option. Your neurological team will help determine the best course of treatment for you by weighing the pros and cons and treatment benefit versus risk. Your neuro-radiologist will perform ongoing MRI scans to check how quickly your tumor is growing. If the tumor’s growth is slow and stable, usually no immediate treatment is necessary.

Acoustic neuroma treatment may include:

  • Surgery: Surgery can successfully remove an acoustic neuroma tumor through the inner ear. You will be placed under general anesthesia and a small portion of the skull will be removed to allow access to the brain where the tumor is located. The entire tumor is not always removable through surgery, and possible complications of surgery may mean it is not the best choice for everyone.
  • Stereotactic radiosurgery: Radiosurgery is a single treatment which can be useful for small tumors, or if you cannot tolerate traditional surgery. Radiosurgery may include CyberKnife® or Gamma Knife® treatment, which can be performed on an outpatient basis with no anesthesia. The procedure works by delivering a precise, targeted dose of radiation to the tumor based on its location, as identified by imaging scans.
  • Supportive therapies: Treatment from your neurology team is focused primarily on removing or stopping the growth of your tumor, but you may also receive recommendations to treat hearing loss, dizziness, or balance problems.

Request an appointment online now or call 833-656-3876.