Acoustic Neuroma

Acoustic neuroma refers to a non-cancerous tumor in the cranial nerve that connects the inner ear to the brain.

This nerve is involved in hearing and balancing. Acoustic neuroma grows slowly over a period of time and as it increases in size, it results in hearing loss and imbalance while walking.

In some cases, the tumor may grow rapidly and press against brain, which is life-threatening. It may result in paralysis of the face.

Symptoms of acoustic neuroma resembles that of middle ear problems, and hence it is difficult to diagnose.

Surgery and radiation therapy are the two treatment options for the tumor.

Symptoms due to acoustic neuroma depend on the effects it has on the main cranial nerve and also on other organs that it presses upon.

Gradual loss of hearing is one of the most common symptoms of acoustic neuroma.

In some rare cases, the hearing loss may be sudden and more pronounced on one side. Other symptoms include:

• Loss of balance while walking
• Vertigo
• Numbness or tingling feelings in the face
• Difficulty in swallowing
• Hoarseness in voice
• Headache
• Confusion
• Clumsiness

Some of the symptoms mentioned above, particularly confusion and clumsiness, are serious and require immediate medical attention.

Based on the cause, acoustic neuroma is separated into two forms:

• Sporadic form – this is the most common form of acoustic neuroma and the actual cause for the formation of tumors is not clear.

        -Radiation is considered to be a major risk factor in the development of sporadic form of acoustic neuromas.

• Associated with a syndrome – neuroma may be associated with NF2 syndrome (neurofibromatosis type II).

This is an inherited disorder and leads to the formation of non-cancerous tumors.

Acoustic neuromas are characterized by subtle symptoms and hence are difficult to diagnose at an early stage.

Diagnosis is complicated as the symptoms resemble that of middle ear and inner ear disorders.

Confirmatory diagnosis is done by ear examination and hearing tests. For early detection, CT scans and MRI are helpful.

In a hearing test, sounds of different tones and intensity are directed to the ear to assess the hearing ability.

In some cases, an auditory brain stem response test is recommended. This test identifies the passage of messages from the inner ear to the brain stem.

Watchful waiting, surgery and radiation therapy are the three treatment methods for acoustic neuroma.

Acoustic neuroma is non-cancerous and grows very slowly. Thus, immediate treatment may not be needed in many cases.

Doctors may suggest observation for some time, assessing their growth and effect on neighboring areas.

Periodic MRI scans are recommended to check the growth of the tumor.

Surgical method

All parts of the tumor are removed using surgical methods. The type of surgical method used depends on the size of the tumor.

If the size of the tumor is larger than 3cm, the tumor is removed by making an incision at the back of ear. To avoid hearing loss, the tumor may also be removed by opening the skull at the back of head to reveal the tumor.

When the tumor is small, it is usually removed by taking a piece of bone from the ear canal. Endoscopic resection is a method which helps to remove the tumor by a minimally invasive procedure.

In radiosurgery, a gamma knife is used to reduce the size of the tumor. It may also help to hinder the growth of the tumor.

Non-surgical method

In radiation therapy, high doses of radiation are applied on the tumor with limited exposure to surrounding tissues.

In another method, smaller doses of radiation are delivered daily for weeks.

Alternative and homeopathic remedies like Chinese herbal medicines and acupuncture are used to control pain and headaches associated with neuroma.

These methods are considered to be good for hearing restoration and also to control facial paralysis.

However, there is no scientific evidence to support the effectiveness of these methods.

Turmeric supplements are considered to be effective in preventing the growth of tumor.

Gingko is also suggested in homeopathy for reducing tinnitus.

There are several ways to adapt your lifestyle in coping with acoustic neuroma.

Acoustic neuroma can cause hearing loss and paralysis, two symptoms that may make the patients stressed out.

Knowing more about the symptoms, treatment and remedies of acoustic neuroma may help in reducing stress and to develop a positive attitude. It will also help in choosing the right treatment strategy.

Developing a good support group also goes a long way in coping with the condition.

There are several factors that increase the risk and affect complications of acoustic neuroma.

Family history of the genetic disorder NFII is the most important risk factor in acoustic neuroma. It is an autosomal dominant disorder, in which each child has equal chances of getting the disorder.

Exposure to radiation, particularly in the head and neck region, is another risk factor for acoustic neuroma. This disorder is associated with complications like:

• Hearing loss
• Facial paralysis
• Facial weakness
• Loss of balance
• Tinnitus or ringing in the ear

If the tumors are large, it may affect the flow of cerebrospinal fluid resulting in increased pressure within brain.