Acoustic neuroma

General Features

  • An acoustic neuroma is a benign Schwann cell-derived tumor of the eighth cranial nerve.
  • Also known as a vestibular schwannoma.
  • Usually unilateral
  • In neurofibromatosis type 2, acoustic neuromas are typically bilateral.

Signs and Symptoms

  • Progressive, unilateral sensorineural hearing loss
  • Unilateral tinnitus
  • Continuous vertigo
  • Headache
  • Facial numbness or weakness if tumor grows to involve the trigeminal nerve or facial nerve.

Diagnosis and Management

  • Imaging of choice is MRI. Vestibular schwannomas can also be detected with CT scan.
  • Audiometry may be performed initially to confirm asymmetric sensorineural hearing loss.
  • Management may include observation with serial MRIs, surgery, or focused radiation.
  • Treatment depends on many factors including the patient’s age and health, severity of hearing loss, and tumor size.