What is acoustic neuroma?
Acoustic neuroma, also called vestibular schwannoma, is a type of benign (noncancerous) tumor that develops on the auditory nerve—the nerve that connects your inner ear to your brain and controls hearing and balance.
Most vestibular schwannoma tumors are small and affect only one ear. They grow about one to two millimeters each year. However, some tumors can grow more rapidly. About 33 percent of tumors don’t grow at all, and one to two percent get smaller without any treatment.
A rare, hereditary type of acoustic neuroma called NF2-related schwannomatosis can develop in both ears. It is most common during teen or early adult years.
Symptoms of acoustic neuroma
Most acoustic neuromas grow very slowly. As the tumor gets larger, it presses on nearby nerves, blood vessels, and the surface of the brain stem and cerebellum (the base of the brain). This pressure leads to symptoms of acoustic neuroma such as:
- Gradual loss of hearing in one ear (often the first symptom)
- Ringing in the ear (tinnitus)
- Clogged feeling in the ear
- Sudden hearing loss
- Loss of balance, clumsiness, or unsteadiness
- Spinning feeling (vertigo), confusion, and headaches
- Numbing, tingling, or face weakness
- Difficulty swallowing, hoarseness, and changes in taste
Acoustic neuroma diagnosis
Your healthcare provider may suspect an acoustic neuroma diagnosis based on your medical history, an exam of your nervous system, or other diagnostic tests.
Tests that are commonly used to diagnose acoustic neuroma from other causes of dizziness or vertigo are included below. Computerized tomography (CT) may also be used to diagnose acoustic neuromas, but CT scans may miss smaller tumors.
Acoustic neuroma treatment at Penn Medicine
Treatment for acoustic neuromas is often dictated by the size of the tumor at the time of diagnosis. Small tumors in the internal auditory canal (IAC) can be watched for growth with regular exams through a practice called “active surveillance,” while large tumors that squeeze the brainstem need to be removed surgically. In both cases, shared decision making between you and your Penn Medicine care team is the basis for determining the course of treatment.
Other factors that can determine your acoustic neuroma treatment plan include the location of the tumor, your age, and overall health. You and your provider should decide whether to watch the tumor without treatment, use radiation treatment to stop it from growing, or try to remove it through surgery.
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