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Facts about acoustic neuroma (AN)

Vestibular schwannoma

About symptoms, diagnosis and treatment methods of a vestibular schwannoma

Read this article to find out what an acoustic neuroma is, what signs are associated with it in its initial phase and in the further course of the disease, and how the benign tumour can be treated. If you also notice hearing loss, you can have your hearing tested free of charge at an Amplifon centre

What is an acoustic neuroma?

What is an acoustic neuroma (AKN)? An acoustic neuroma (also called vestibular schwannoma) is a benign tumour that grows inside the skull. This can interfere with hearing by putting pressure on the nerves. 

Symptoms – hearing loss, tinnitus & Co.

As a rule, acoustic neuroma can trigger symptoms such as:

  • slight dizziness
  • Poor hearing (usually only in one ear)
  • ringing in the ears
  • Balance problems
  • Numbness in the face
  • Gait unsteadiness

Signs in the early disease stage

The signs are hardly noticeable at first. This is because the brain can often still compensate for initial impairments. Since the disease is rather rare, acoustic neuroma symptoms are often misdiagnosed in the early stages. Even if the dizziness and ear problems then increase, the doctor may initially assign the symptoms of acoustic neuroma to other causes. 

For example, the ringing in the ears caused by the acoustic neuroma may be interpreted as tinnitus, the one-sided hearing loss as hearing loss or other causes of hearing problems, and the dizziness as rotary vertigo. Facial numbness and acoustic neuroma facial paresis (facial paralysis) can also be attributed to triggers such as inflammatory diseases in their early stage.

Acoustic neuroma vertigo

However, acoustic neuroma vertigo is different in nature from rotational vertigo, which is caused by diseases in the inner ear. The vertigo is described often as a feeling that the ground seems to be swaying. Acoustic neuroma vertigo appears suddenly, but also passes quickly.

Progression of the disease

As the tumour grows, the symptoms also become clearer. With large tumours, acoustic neuroma can cause headaches and movement disorders and lead to further complications. It is therefore important to keep the tumour under regular observation and have it treated in due time.
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Possible causes of an acoustic neuroma

Ringing in the ears, such as in tinnitus and in one-sided hearing loss, can also be caused by an ailment not exclusively in the ear: In rare cases, they can be triggered by an acoustic neuroma (also known as vestibular schwannoma in medical terminology). This is a benign tumour that grows in the head and can disturb a person's hearing ability by putting pressure on the nerves. 

The tumour usually grows in the ear canal (intrameatal acoustic neuroma) towards the brain stem. The tumour is benign, which means that it does not form metastases, i.e. offshoots. Even if the term tumour immediately makes you think of cancer: Don't worry, it's not cancer. 

The common disease progression

The tumour presses on the cranial nerve to a greater or lesser extent, depending on its size, and thus causes disturbances. The acoustic neuroma experience shows that in some cases the tumour hardly grows any further. If the symptoms are minor, the tumour only needs to be observed at first. However, in order to avoid possible late effects of acoustic neuroma, treatment is necessary sooner or later: The alternatives are radiation or surgery. 

Since the course of the disease varies greatly it is difficult to know just how long a person has been suffering fromacoustic neuroma. Not to mention, acoustic neuroma can recur. It can come back years later even after it has been completely removed. Fortunately, these cases are very rare. Anyone who is affected by a vestibular schwannoma can look up the experiences and opinions of others online in an acoustic neuroma forum, such as the Swiss Guido Fluri Foundation.

Treatments through radiation or surgery

If the acoustic neuroma exceeds a certain size or leads to real impairments due to an unfavourable location even when if is small, treatment is inevitable. The two alternatives of acoustic neuroma therapy are:

  • Acoustic neuroma radiation
  • Removal through acoustic neuroma surgery

Diagnosis with an MRI

If your doctor suspects an acoustic neuroma due to ringing in the ears and one-sided hearing loss, they will check this with an MRI. They will then refer you to a radiologist, where you will then go into the "tube". The images taken here wil show you whether a tumour is the cause of the hearing disorder. 

The frequency of acoustic neuroma is rather low: statistically, there is one case per 100,000 inhabitants per year. Specialists for acoustic neuromas are ENT doctors in the first diagnostic step, then neurologists and neurosurgeons.

Acoustic neuroma radiation

Acoustic neuroma therapy through radiation is considered for tumours that are less than 2 cm in diameter. This acoustic neuroma treatment can stop further growth or a reduction in size. A newer and more precise radiation method is stereotactic radiation, often known under the brand name of one provider, Cyberknife. 

Here, a radiosurgeon robotically irradiates the tumour only once, but with a particularly high dose of radiation. As with all radiation treatments, some patients have side effects after treatment with Cyberknife. Acoustic neuroma radiation side effects are usually headache and fatigue, sometimes also nausea.

Surgery of an Acoustic neuroma

Acoustic neuroma surgery is usually recommended. The removal is usually done by microsurgery. The acoustic neuroma surgery risks are the typical surgery risks. The treating doctor will inform you as a patient in detail before the vestibular schwannoma operation. The doctor will also inform you about the exact course of the operation. Depending on the location and size of the tumour, the duration of the acoustic neuroma operation can vary between one and eight hours. Acoustic neuroma surgery specialists are usually neurosurgeons.

Reports and personal acoustic neuroma surgery experiences and testimonials about acoustic neuroma Cyberknife treatments can be found in various online forums.

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