What is an acoustic neuroma?

An acoustic neuroma is also called a vestibular schwannoma. It's a benign (non-cancerous) tumour that slowly grows in your brain.

As the tumour grows, it presses on part of your auditory nerve. This nerve helps control your balance and hearing. If you have an acoustic neuroma, it may affect your hearing first.

The tumour will continue to grow if it is not treated.

What are the symptoms of an acoustic neuroma?

Usually, acoustic neuromas grow very slowly. This means that you may not have any symptoms when the tumour is small. The most common first symptom is hearing loss on one side.

The symptoms you have can depend on the size of the tumour and how hard it presses on your nerves.

If you have an acoustic neuroma or vestibular schwannoma, you might notice:

• hearing loss
• tinnitus (ringing in the ears)
• loss of balance, dizziness or vertigo (a feeling that the space around you is spinning)
• headache
• facial numbness or tingling
• blurred vision
• problems with coordination on one side of your body

Usually only one side is affected and your hearing slowly gets worse.

Both ears can be involved if you have a rare genetic disease called neurofibromatosis type 2. Neurofibromatosis is a genetic condition which causes benign tumours to grow.

What causes an acoustic neuroma?

The cause of acoustic neuroma is not always known.

If you have been exposed to radiation, that might increase your chance of getting an acoustic neuroma. A few people who have an acoustic neuroma also have neurofibromatosis type 2.

For most people, there is no known cause.

When should I see my doctor?

See your doctor if you get hearing loss, especially if it's only on one side.

Also, see your doctor straight away if you also have any of the following symptoms:

• poor balance
• facial pain
• numbness or twitching
• double vision
• speech problems
• swallowing problems

How is an acoustic neuroma diagnosed?

Your doctor will ask about your symptoms and your family health history. They will examine you. You may be referred to an ear, nose and throat (ENT) specialist.

If your doctor thinks you could have an acoustic neuroma, they will send you for tests, such as:

• hearing tests
• a magnetic resonance imaging (MRI) scan
• a computed tomography (CT) scan

An MRI lets your doctor see if you have an acoustic neuroma. The scan also shows the size and location of the tumour.

Your doctor may find an acoustic neuroma or vestibular schwannoma when you have an MRI for another reason. In this case, your MRI report will say it is an 'incidental finding'.

How is an acoustic neuroma treated?

Your treatment will depend on:

• the size and location of the acoustic neuroma
• your symptoms
• your age
• your general health
• your preferences

Your doctor will talk to you about the best treatment based on your symptoms and preferences.

After your doctor explains the options, you can give informed consent. This is when you agree for your healthcare team to give you treatment and care.

You may decide to closely monitor the tumour, have surgery or have radiation treatment.

Watch and wait

If you and your doctor decide to 'watch and wait' you will be closely monitored.

You will have scans every 6 months to 2 years. These will check to see if your acoustic neuroma is growing. Your symptoms will also be monitored.

Surgery

It may be best to have surgery to remove the tumour if:

• you are fit and healthy
• the acoustic neuroma is large

Ask your doctor or surgeon about the aim of the surgery. This could depend on exactly where the tumour is and how much hearing loss you have.

If you have poor general health, having surgery could have more risk.

Find out more about preparing to have surgery.

Radiation treatment

Focused radiation is another way to treat acoustic neuroma or vestibular schwannoma.

Stereotactic radiotherapy uses radiation to help stop the tumour from growing.

Before you decide on your treatment, ask your doctor about the benefits and risks of each option.

Living with an acoustic neuroma or vestibular schwannoma

You may decide to do nothing and just carry on with life knowing that the tumour is there.

If your hearing was good before the acoustic neuroma, there is a good chance that you will keep some of your hearing.

Remember, an acoustic neuroma or vestibular schwannoma is not cancer, and will not spread to other parts of your body.

What are the complications of an acoustic neuroma?

Although acoustic neuromas are not cancerous, they can cause distressing symptoms and lasting hearing and balance problems.

Some acoustic neuromas can cause serious, lasting damage, if they're not treated.

You can also get complications from radiation treatment or surgery.

Resources and support

Visit the Acoustic Neuroma Association Australia for support and information.

Visit the Brain Foundation for more information about conditions of the brain.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.