Understanding the 3 Main Symptoms of Acoustic Neuroma

Understanding the 3 Main Symptoms of Acoustic Neuroma

Pamela Bandelaria |Jan 20, 2022

Acoustic Neuroma Symptoms

Have you heard about a condition called acoustic neuroma? You might have heard it mentioned a few times, as it might not be as common as other tumors. In the U.S., around 2,000 to 3,000 people are diagnosed annually. Data shows that it afflicts 1 person per 100,000 per year. Although its incidence is not at an alarming rate, it is worth knowing a thing or two about this condition, as it can bring a lot of discomfort and disability to those who experience it. If you have not heard about acoustic neuroma before, this is the best time to know what it is. This article will explain what acoustic neuroma is, how it occurs and the common acoustic neuroma symptoms.

What is Acoustic Neuroma?

Acoustic neuromas are benign tumors that commonly arise from the vestibular nerve, a part of the eighth cranial nerve, which is responsible for maintaining balance through signals sent to and from the inner ear.

Acoustic neuromas are also called vestibular schwannomas, a term that better describes the tumor as it is due to the tumor’s overproduction of the Schwann cells, accessory cells that produce the protective myelin sheath of nerve cells. These usually occur in the cerebellopontine angle, a small triangle between the cerebellum and lateral pontine area where are a lot of cranial nerves pass, among them the eighth cranial nerve, which is affected in acoustic neuromas. Around 80% to 90% of tumors in this area are schwannomas, with the rest being meningiomas (tumors of the meninges).

The majority of acoustic neuromas are usually unilateral, that is it occurs on one side of the body. Bilateral tumors tend to occur especially in patients with another condition called type 2 neurofibromatosis, which more commonly occurs in children. Acoustic neuromas usually start to occur in patients aged 40 to 60 years old, with bilateral tumors associated with type 2 neurofibromatosis occurring at a younger age (30 years old). There is an equal incidence between males and females.

What Are the Symptoms?

Because of its usual occurrence in the cerebellopontine angle and the involvement of the eighth cranial nerve, the symptoms of acoustic neuroma are associated with the function of the structures in these areas. The vestibular nerve plays a role in balance and position, while the cochlear nerve plays a role in hearing. Naturally, a tumor involving these areas would cause problems with hearing and balance.

1. Hearing Loss

The most common presenting symptom of acoustic neuroma is unilateral hearing loss. This is due to the tumor causing a block in the cochlear nerve or in its blood supply and occurs in 90% of people with acoustic neuroma. Aside from it being the most common presenting symptom, it is also one of the earliest symptoms of the condition. It is sometimes not detected immediately and can be dismissed in the early stages. It can even be undetected for years.

However, once it occurs, it can worsen as time passes. Because acoustic neuromas are usually unilateral in nature, the hearing loss is also unilateral, but it can also be bilateral in some cases. The hearing loss can also be accompanied by a sensation of ear fullness, which people can describe as having pressure or the sense of having water inside the ear.

2. Tinnitus

Another common symptom is tinnitus, wherein a certain noise is heard in the ears. The noise heard is usually a ringing, buzzing, or whistling sound. In acoustic neuromas, this is usually an intermittent, high-pitched sound due to the tumor. If the tumor is removed, tinnitus usually disappears in around 30% to 60% of cases. However, in a small group of individuals, tinnitus remains and may sometimes get worse even after the tumor is removed.

3. Balance Changes

Other common symptoms of acoustic neuromas are loss of balance, dizziness, or vertigo. This is because the vestibular nerve is affected, which plays a role in balance. This can occur in up to 50% of affected patients and worsens as the tumor grows. If the tumor grows big enough, it can compress the brainstem and cause problems in gait with the person falling on the side of the tumor. Dizziness or vertigo, which is a spinning sensation, can also be experienced once the tumor is large enough.

The following are other symptoms of acoustic neuromas:

  • Facial numbness.
  • Headaches.
  • Loss of facial muscle movement.
  • Facial twitching.
  • Problems swallowing.
  • Changes in sense of taste.
  • Dry eyes or excessive tearing.

It can sometimes be hard to diagnose acoustic neuromas immediately because symptoms such as hearing loss, dizziness, or tinnitus can also be caused by common ear problems. Moreover, these are symptoms where some people will not get a consult immediately, which can further cause a delay in the diagnosis.

Fortunately, acoustic neuromas are benign tumors and patients generally have a good response to treatment. Complications are also not common and are minimal.

Although symptoms may persist, in most cases they disappear. Tumors also rarely reoccur. However, prompt diagnosis and management are important, as acoustic neuroma can still worsen and be fatal if it is left untreated due to an increase in tumor growth, which can compress brain structures and lead to fluid buildup in the brain. This is why the evaluation by a trained professional is important. Acoustic neuromas are not a cause of worry once you know the signs and symptoms and get checked early.

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