Acoustic Neuroma (AKA Vestibular Schwannoma)
What is a vestibular schwannoma?
Where exactly is this tumor?
Is this cancer?
Is this life threatening?
What symptoms does it cause?
The symptoms are caused by compression of nerves the tumor pushes against.
- Hearing loss in one ear – sudden or gradual
- Tinnitus (ringing)
- Imbalance or dizziness
- Facial numbness
- Facial weakness
How can you know that it is a vestibular schwannoma without a biopsy?
It is true that there is no way to know definitively without a biopsy, however we can often tell based on the MRI you had. When there is a tumor in this part of the brain 85% are vestibular schwannomas, 10% are meningiomas (also benign), and the remaining 5% are a variety of very rare tumors.
What caused me to get this tumor?
Usually random chance. There is a genetic disease called neurofibromatosis type 2 where patients grow vestibular schwannomas on both sides, but this is extremely rare.
How fast does it grow?
What is going to happen to my hearing in that ear?
How are vestibular schwannomas treated?
There are three potential options for managing a vestibular schwannoma. Not all options are appropriate for all patients. Your doctor will tell you which option(s) are appropriate for you.
Observation with Regular MRI Surveillance
Stereotactic Radiotherapy
Surgical Removal
What are the risks of surgery?
- Hearing loss – Surgery is the best chance at long term hearing preservation in properly selected patients, however there is a substantial risk of losing hearing during the surgery itself.
- Facial weakness – The tumor is always touching the facial nerve. There is a risk of temporary or permanent facial weakness from surgery. A facial nerve monitor is used to help avoid this.
- Dizziness – Surgery can often help with chronic dizziness, however it can also cause worsened dizziness in the short term.
- Cerebrospinal fluid leak – Approximately 5% of cases are complicated by a brain fluid leak.
Incomplete excision – Sometimes if the tumor is tightly adhered to the facial nerve or brainstem, some of the tumor is left in order to avoid complications. It is sometimes necessary to perform stereotactic radiosurgery on this remnant later. - Less common risks – wound complications, infection, meningitis, stroke, seizure, facial numbness, death.
These are uncommon but serious risks.