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Acoustic Neuroma

What is an Acoustic Neuroma?

An acoustic neuroma, also called a vestibular schwannoma, is a benign (noncancerous tumor). It usually grows slowly on the vestibular nerve, which is the nerve that connects the inner ear to the brain.

This nerve helps control hearing and balance. You have one on each side of your head.

What is a Happening in My Body?

As the tumor grows, it may press on the hearing and balance nerve. This can cause:

  • Hearing loss, usually in one ear
  • Ringing in one ear, called tinnitus
  • Unsteadiness or balance problems
  • Dizziness or vertigo

Symptoms often develop slowly. However, hearing loss can sometimes happen suddenly.

A large tumor may press on nearby nerves or parts of the brain. This may cause facial numbness, facial weakness, headaches, or other symptoms.

It is important to know:

  • You did not cause this
  • Many people live full lives with the right care
  • Symptoms can change over time
  • The tumor is not cancer
  • This tumor will not spread to other parts of the body
  • Symptoms and tumor growth can change over time.

How is an Acoustic Neuroma Diagnosed?

A hearing test may show hearing loss or reduced word understanding in one ear. If the results are different between the ears without a clear reason, more testing may be needed.

An MRI with contrast is the best test to find an acoustic neuroma. It can show even a small tumor and where it is located. If an MRI cannot be done, a hearing nerve test called an ABR may be used, but it can miss small tumors.

Dizziness by itself is more often caused by another balance condition.

What Your Provider May Ask:

Your provider may ask:

  • Do you have hearing loss, ringing in your ear, or balance problems?
  • Is your hearing worse in one ear?
  • When did your symptoms begin?
  • Are your symptoms getting worse?
  • Have you noticed facial numbness or weakness?

How is an Acoustic Neuroma Treated?

Not every acoustic neuroma needs treatment right away. Treatment depends on the tumor’s size, growth, symptoms, hearing, age, and your preferences.

Monitoring: Small tumors that cause few symptoms may be checked over time with regular MRI scans.

Radiation: Focused radiation can help stop a small or medium tumor from growing. It does not remove the tumor.

Surgery: Larger or growing tumors may need to be removed. Surgery can affect hearing, facial movement, or balance.

Vestibular rehabilitation: Balance and eye exercises can help with dizziness, unsteadiness, and walking, especially after surgery.

Some people may begin balance exercises before surgery. This is called prehabilitation and may help prepare the body for recovery.

It may be helpful to get a second opinion from a team with experience treating these tumors. This team may include a neurotologist, who specializes in the ear and nearby nerves, and a neurosurgeon, who specializes in the brain and nerves.

What Can I Expect Over Time?

Your provider will watch your symptoms, hearing, and tumor size. Some tumors grow very slowly or stop growing.

Treatment may affect hearing, balance, or facial movement. Your care team should explain the possible benefits and risks of each option.

When Should I Call My Provider?

Call your provider right away if you have:

  • Sudden hearing loss
  • New facial numbness or weakness
  • Symptoms that are quickly getting worse
  • Ongoing vomiting or severe balance problems

Call 911 or seek emergency care for:

  • A sudden, severe headache
  • Weakness or numbness on one side
  • Trouble speaking, seeing, or walking
  • Fainting
  • A seizure
  • Severe confusion

Always tell your provider about any new symptom that worries you.

Questions to Ask Your Provider

  • How large is my tumor?
  • Has it grown?
  • How often will I need an MRI or hearing test?
  • What symptoms should I watch for?
  • Do I need monitoring, radiation, or surgery?
  • What are the benefits and risks of each choice?
  • How could treatment affect my hearing and balance?
  • Should I get a second opinion?

Key Points to Remember

  • Acoustic neuroma is usually slow-growing and noncancerous.
  • Common signs include hearing loss or ringing in one ear and balance problems.
  • MRI is the main test used for diagnosis.
  • Treatment may include monitoring, radiation, or surgery.
  • Vestibular rehabilitation may help with dizziness and balance.

Additional Resources