An acoustic neuroma (also called vestibular schwannoma) is a non-cancerous slow growing tumor affecting an important nerve that sends sound and balance information from the inner ear to the brain Acoustic neuromas, are not very common but may occur in up to 1 in 10,000 people. Because acoustic neuromas affect the sound and balance information going to the brain The early signs and symptoms are usually a gradual, unexplained loss of hearing in one ear, usually loss of high frequency hearing, often accompanied by ringing or hissing in the ear (tinnitus) or a feeling the ear is plugged or "full". Unsteadiness and balance problems or even vertigo (the feeling like the world is spinning), may occur as the tumor grows. Facial numbness or weakness can occur in some cases as well. Early symptoms are sometimes mistaken for the normal changes of aging which can delay an accurate diagnosis. It's important to see your doctor if you experience these symptoms. More severe symptoms of acoustic neuroma such as clumsiness and mental confusion can signal a serious problem that requires urgent treatment.
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Signs and symptoms of acoustic neuroma are likely to develop gradually and some of the symptoms such as hearing loss can look like normal changes of aging or indicators of other middle and inner ear problems. This can make it challenging to diagnose acoustic neuroma in its early stages. After asking questions about your symptoms, your doctor will conduct an ear exam. Your doctor may order the following tests:
Hearing test (audiometry). In this test, conducted by a hearing specialist (audiologist), you hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear the sound. Each tone is repeated at faint levels to find out when you can barely hear.The audiologist may also present various words to determine your hearing ability. Scans. Magnetic resonance imaging (MRI) or computerized tomography (CT) scans of your head can provide images that confirm the presence of an acoustic neuroma.
Your acoustic neuroma treatment may vary, depending on the size and growth of the acoustic neuroma and if you're experiencing symptoms. Most of these tumors are very slow-growing and many do not grow at all after discovery. Small tumors that do not pose a risk to brain function and do not produce symptoms, may be watched with follow-up MRI scans to insure the neuromas are under control. This is most often a good option for older individuals with small tumors. If the scans show the tumor is growing or if the tumor causes progressive symptoms or other difficulties, you may need to undergo treatment. When treatment is needed, however, the patient and their family should understand their options including the success rates, potential complications, and implications for follow-up. The gold standard for treatment is surgical removal - but the hearing is often sacrificed. There is also radiation therapy available for acoustic neuroma - usually delivered in the single dose - and referred to a stereotactic radiotherapy. Radiosurgery such as Gamma Knife radiosurgery is a non-invasive treatment (without making an incision) that uses precisely focused, narrow beams of radiation which treat the acoustic neuroma and minimize the dose of radiation delivered to the surrounding tissues including the hearing, balance and facial nerves. Risks of radiosurgery include hearing loss, ringing in the ear, facial weakness, facial numbness, balance problems and treatment failure (continued tumor growth). Very rarely, the radiation could cause a cancer in the treated area in the future. Currently surgical removal is the treatment that shows a long-term high cure rate and only when the vast majority of the tumor is completely resected (removed), but significant portions of the tumor left behind present a significant risk of regrowth. Surgery can also result in complications.
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