An acoustic neuroma is a type of schwannoma, specifically a non-cancerous tumor that forms on the vestibulocochlear nerve, which controls hearing and balance. Schwannomas are tumors that develop from Schwann cells, which can grow on any peripheral or cranial nerve. Therefore, an acoustic neuroma is a specific, and the most common, type of schwannoma that develops in the brainstem area.

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Schwannoma (Acoustic Neuroma) – Complete Overview for Blog

A Schwannoma, also known as an Acoustic Neuroma or Vestibular Schwannoma, is a non-cancerous (benign) tumor that develops from Schwann cells. These cells form the protective myelin sheath around nerves. When they multiply abnormally, they form a slow-growing tumor—most commonly on the vestibulocochlear nerve (8th cranial nerve), which is responsible for hearing and balance.

Although benign, the tumor can grow over time and press on important structures in the brain, so timely diagnosis and treatment are important.

What Is Acoustic Neuroma?

Acoustic Neuroma is a benign tumor arising from the vestibular portion of the hearing and balance nerve.
It does not spread (non-metastatic), but can grow slowly and affect:

  • Hearing

  • Balance

  • Facial sensation

  • Facial movements (rarely)

Causes of Schwannoma

1. Sporadic (Most Common)

In most people, acoustic neuromas occur without a known cause.

2. Genetic Cause – Neurofibromatosis Type 2 (NF2)

A small percentage of patients develop Schwannomas due to NF2 gene mutation, often leading to:

  • Bilateral acoustic neuromas (tumors on both hearing nerves)

  • Other nerve tumors

NF2 is inherited, but sporadic mutations can also occur.

Who Is at Risk?

  • Adults aged 30–60

  • People with family history of NF2

  • Radiation exposure to head/neck (rare factor)

Common Symptoms of Acoustic Neuroma

Symptoms typically develop gradually:

1. Hearing Problems

  • Unilateral hearing loss (one-sided) — most common

  • Difficulty hearing in noisy environments

  • “Fullness” feeling in the ear

2. Tinnitus

  • Ringing, buzzing, or hissing sound in one ear

3. Balance Issues

  • Unsteady walking

  • Vertigo (less common compared to other inner-ear disorders)

4. Facial Symptoms (When tumor grows larger)

  • Numbness or tingling in the face

  • Weakness of facial muscles

  • Rarely, facial paralysis

5. Large Tumor Symptoms

  • Headaches

  • Pressure in the head

  • Hydrocephalus (fluid buildup) in severe cases

How Is Schwannoma Diagnosed?

1. Hearing Tests (Audiogram)

Shows one-sided sensorineural hearing loss.

2. MRI Scan

Gold standard for diagnosis.
Identifies tumor size and exact location.

3. CT Scan

Used when MRI is not possible.

Types Based on Location

Although “acoustic neuroma” is the common term, Schwannomas can occur on:

  • Vestibular nerve (most common)

  • Cochlear nerve

  • Facial nerve

  • Other cranial or peripheral nerves

Treatment Options

Treatment depends on:

  • Tumor size

  • Growth rate

  • Symptoms

  • Patient age & health

1. Watchful Waiting (Observation)

For small tumors with mild symptoms.
Regular MRI scans (6–12 months) are done to monitor growth.

2. Radiation Therapy

Used for small to medium tumors:

  • Stereotactic radiosurgery (SRS) – Gamma Knife

  • Fractionated radiotherapy

Goal: Stop tumor growth while preserving hearing and nerve function.

3. Surgical Removal

Recommended for:

  • Larger tumors

  • Tumors causing brain compression

  • Rapidly growing tumors

  • Patients with significant symptoms

Surgical approaches include:

  • Translabyrinthine (hearing lost but full access)

  • Retrosigmoid (can preserve hearing)

  • Middle fossa (for small tumors with serviceable hearing)

Risks include:

  • Hearing loss

  • Facial nerve weakness

  • CSF leak

  • Balance difficulty (temporary)

Prognosis

Acoustic neuroma is not cancer, and most patients have excellent outcomes with treatment.
With early diagnosis:

  • Hearing may be preserved

  • Facial nerve function can be protected

  • Tumor control rates with surgery or radiation are high

Complications (If Untreated)

  • Permanent hearing loss

  • Severe balance issues

  • Compression of brainstem

  • Hydrocephalus

  • Rarely, life-threatening complications

Prevention

There is no specific prevention, but early diagnosis helps avoid complications.
People with family history of NF2 may need genetic counseling and regular screening.

Key Takeaways

  • Schwannoma/Acoustic Neuroma is a benign, slow-growing nerve tumor.

  • Main symptoms: one-sided hearing loss, tinnitus, and balance problems.

  • Diagnosis is usually confirmed with MRI.

  • Treatment includes observation, radiation therapy, or surgery depending on tumor size.

  • Early detection leads to better outcomes.

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