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Patient education: Vestibular schwannoma (acoustic neuroma) (The Basics)

Patient education: Vestibular schwannoma (acoustic neuroma) (The Basics)

What is a vestibular schwannoma? — A vestibular schwannoma is a growth on the nerve that goes from the ear to the brain. It can cause hearing loss and balance problems. Another name for a vestibular schwannoma is "acoustic neuroma."

Vestibular schwannomas are more common in adults than in children. They usually happen in just 1 ear, but a few people get them in both ears.

Some people have a higher risk of getting a vestibular schwannoma. They include:

People who have a disease called "NF2-related schwannomatosis," or "NF2" – This disease causes growths in different parts of the body. It can run in families. If someone in your family has NF2, you could have a higher risk of getting a vestibular schwannoma.

People who had head and neck radiation treatment in childhood – This can cause a vestibular schwannoma many years later.

What are the symptoms of a vestibular schwannoma? — The symptoms include:

Hearing loss – This can happen over many years. A person might not realize they do not hear as well as before.

Tinnitus – This is when a person has ringing, buzzing, hissing, or roaring sounds in 1 or both ears.

Balance problems when walking

A feeling of tilting to 1 side

Face symptoms – These can include:

Numbness

Pain

Trouble moving part of the face

Is there a test for vestibular schwannoma? — Yes. The doctor or nurse will do an exam and learn about your symptoms. They can order the following tests:

A test called an "audiogram" – In this test, you put on a headset. A hearing specialist (called an "audiologist") plays sounds in 1 ear at a time. They ask you to signal when you hear the sounds. The test shows if you have hearing loss that could be from a vestibular schwannoma or another condition. It also shows whether both ears are affected the same way.

Imaging tests, such as a brain MRI scan – This test creates picture of the inside of the brain. It can show a vestibular schwannoma or other growth that is causing symptoms.

How is a vestibular schwannoma treated? — Treatments include:

Surgery – Taking out the vestibular schwannoma can help you keep the hearing you still have. But if you already lost some hearing, surgery will not usually bring it back.

Radiation – This treatment uses high doses of X-rays to keep the vestibular schwannoma from growing and causing more symptoms. Some people still lose their hearing gradually after radiation, even though the vestibular schwannoma has stopped growing.

Watchful waiting – This means you wait to see if your symptoms change, but don't have treatment right away. You get an imaging test every year. You will probably also have regular hearing tests. You might have surgery or radiation if the vestibular schwannoma starts growing quickly or starts causing symptoms.

Doctors might recommend surgery or radiation if:

You are younger than many people with vestibular schwannoma.

You have a large vestibular schwannoma.

You have a lot of hearing loss because of the vestibular schwannoma – Without treatment, you could lose all your hearing on the side of the schwannoma. This is more likely if the vestibular schwannoma grows quickly.

Doctors might recommend watchful waiting if:

You are older.

You have a small vestibular schwannoma.

You have not lost much hearing yet.

A vestibular schwannoma can come back after surgery or radiation. If you have either of these treatments, you will probably have an MRI every year for up to 10 years. These imaging tests can show if the vestibular schwannoma is coming back.

More on this topic

Patient education: Age-related hearing loss (presbycusis) (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)

Patient education: Tinnitus (ringing in the ears) (The Basics)
Patient education: Vertigo (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
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