Acoustic neuroma: Signs and treatment

An acoustic neuroma is a rare, non-cancerous tumour that develops on the vestibulocochlear nerve, the nerve responsible for hearing and balance. Also known as a vestibular schwannoma, this slow-growing tumour can affect hearing, balance, and nearby nerves as it increases in size.

Although acoustic neuromas are benign, early diagnosis is important to help manage symptoms and reduce the risk of complications.

What is an acoustic neuroma?

An acoustic neuroma forms from Schwann cells that surround the vestibular nerve, which connects the inner ear to the brain. The tumour usually grows slowly and typically affects only one ear. The acoustic neuroma tumour location is most commonly within the internal auditory canal and the cerebellopontine angle, an area near the brain stem where important nerves related to hearing, balance, and facial movement are located. As the tumour enlarges, it may place pressure on nearby structures, including:

the hearing nerve
balance pathways
facial nerves
in rare cases, the brain stem

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Acoustic neuroma symptoms

Symptoms often develop gradually and may initially be subtle. The most common acoustic neuroma symptoms include:

hearing loss in one ear
tinnitus (ringing in the ear)
dizziness or imbalance
a feeling of fullness in the ear

Because symptoms can appear slowly over time, they are sometimes mistaken for age-related hearing changes or other inner ear conditions.

Acoustic neuroma symptoms and neck pain

Some patients also report acoustic neuroma symptoms with neck pain, especially when muscle tension develops in response to chronic imbalance or discomfort. Neck stiffness may occur alongside dizziness, headaches, or postural compensation caused by balance difficulties.

While neck pain is not usually considered a primary symptom, it can be associated with larger tumours or prolonged vestibular dysfunction.

Symptoms of acoustic neuroma pressing on the brain

In larger cases, the tumour may begin pressing against nearby brain structures. Possible symptoms of acoustic neuroma pressing on the brain stem can include:

persistent headaches
worsening balance problems
facial numbness or tingling
difficulty swallowing
coordination problems

Pressure on the brain stem is uncommon but may require more urgent medical evaluation and treatment.

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How acoustic neuroma is diagnosed

Diagnosis usually begins with a hearing evaluation and imaging tests. MRI is considered the gold standard for detecting acoustic neuromas because it provides detailed images of the inner ear and surrounding nerves.

In some situations, an acoustic neuroma on CT scan may also be identified, particularly when MRI is not possible. However, smaller tumours are generally easier to detect with MRI imaging. Additional tests may include:

audiological assessments
balance testing
neurological evaluation

Specialists such as those at Amplifon Canada may help identify hearing-related symptoms and recommend further diagnostic assessment when needed.

Acoustic neuroma treatment options

The best acoustic neuroma treatment depends on several factors, including:

tumour size
growth rate
patient age and overall health
severity of symptoms

Treatment approaches may include:

regular monitoring with imaging
radiation therapy
surgery

For very small or slow-growing tumours, doctors may recommend observation with periodic MRI scans.

Acoustic neuroma surgery

When the tumour is growing, causing significant symptoms, or placing pressure on nearby structures, acoustic neuroma surgery may be recommended. The goal of surgery is to remove as much of the tumour as safely possible while preserving nearby nerves and functions, particularly hearing and facial movement.

Different surgical techniques may be used depending on:

tumour size
tumour location
hearing preservation goals

Because the tumour develops close to delicate nerves, surgery requires highly specialized expertise.

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If you would like to learn more about the options available to you, come in to your local Amplifon hearing clinic, and our Audiologists/ Hearing care professionals will be able to answer all your questions.

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What to expect from an acoustic neuroma operation

An acoustic neuroma operation is typically performed by a multidisciplinary surgical team that may include neurosurgeons and ENT specialists. Recovery varies depending on the complexity of the procedure and the size of the tumour. Some patients may experience temporary:

dizziness
balance issues
hearing changes
facial weakness

Vestibular rehabilitation and hearing support can play an important role during recovery.

Long-term outlook

Many acoustic neuromas grow slowly and outcomes are often positive when the condition is identified early. Regular monitoring and timely treatment help reduce the risk of complications and support long-term hearing and balance health.

Patients experiencing unexplained hearing loss, persistent tinnitus, or balance problems should seek professional evaluation to determine the underlying cause.

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