Inside the canal, the vestibulocochlear nerve lies next to the facial nerve. The facial nerve seventh cranial nerve is responsible for moving the muscles of the face.
The close relationship of the vestibulocochlear and facial nerves explains why facial weakness can occur when an acoustic neuroma grows Fig. Likewise, facial sensation and feeling is controlled by the trigeminal nerve fifth cranial nerve and can be affected by large tumors. An acoustic neuroma, also called vestibular schwannoma, is a benign, slow-growing tumor that arises from the Schwann cells forming the sheath covering of the vestibulocochlear nerve.
As the tumor grows, it expands from its origin inside the internal auditory canal out into the space between the brainstem and the bone known as the cerebellopontine angle.
The pear-shaped tumor can continue to enlarge, compressing the trigeminal nerve, which is responsible for facial sensation. Eventually, the tumor can compress the brainstem.
Acoustic neuromas are classified according to their size as small less than 1. The symptoms caused by an acoustic neuroma follow the size and growth of the tumor. The most common first symptom is hearing loss in the affected ear, which often goes unrecognized or is mistaken for a normal change of aging.
Small tumors, which are typically limited to the bony canal, cause hearing loss in one ear, tinnitus ringing in the ears , and unsteadiness or dizziness.
As the tumor expands, hearing loss may worsen, facial weakness may occur, and balance problems disequilibrium may occur. Large tumors can compress the brainstem causing imbalance and the trigeminal nerve causing facial numbness.
As brainstem compression becomes severe, the fourth ventricle collapses and hydrocephalus results, causing persistent headache and visual problems. The cause of acoustic neuromas is largely unknown.
No environmental factor such as cell phones or diet has been scientifically proven to cause these tumors. Acoustic neuromas can be sporadic or caused by an inherited condition called neurofibromatosis type 2 NF Neurofibromatosis is a rare disease that occurs in two forms. Type 1 causes tumors to grow on nerves throughout the body, especially the skin. Type 2 can cause acoustic neuromas on both the left and right sides, creating the possibility of complete deafness if the tumors grow unchecked.
The presence of bilateral acoustic tumors affects the choice of treatment, as hearing preservation is a prime objective. Acoustic neuromas affect about 10 people in one million. More women than men are affected. Patients are usually diagnosed between 30 to 60 years of age.
The doctor will ask about your personal and family medical history and will perform a complete physical examination. In addition to checking your general health, the doctor will perform a neurological exam.
This will include checks for mental status and memory, cranial nerve function sight, hearing, smell, tongue and facial movement , muscle strength, coordination, reflexes, and response to pain. Diagnostic tests may include:. Audiogram is a hearing test performed by an audiologist. During the test you will wear earphones and hear a range of sounds at different tones directed to one ear at a time. Also, speech discrimination will be assessed.
The test can detect whether you have hearing loss that is sensorineural from nerve damage or conductive from eardrum or ossicle damage. Electronystagmography ENG is a test that evaluates your balance by detecting eye movements while stressing your balance in various ways. During ENG, eye movements are recorded with small electrodes placed on the skin around the eyes.
Alternatively, eye movements may be recorded by videonystagmography VNG , using an infrared video camera mounted inside goggles that you wear. Magnetic Resonance Imaging MRI is a noninvasive test that uses a magnetic field and radiofrequency waves to give a detailed view of the soft tissues of the brain.
A contrast dye called gadolinium may be injected into the bloodstream during scanning to make tumors more visible. Her responsibilities include the implementation and support of business-wide technology resources and establishing and managing efficient and cohesive organizational operations. Maxine works closely with ABTA leadership to provide strategic direction, systems expertise, vendor management and information to support their priorities.
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Apply for Admission M. Division Otology and Neurotology. Acoustic Neuroma: Overview. Acoustic neuromas are benign tumors diagnosed in 2, to 3, people annually, an incidence of 1 per , per year. Play Video:. Elsevier, Lalwani AK, ed. Vestibular schwannomas. McGraw-Hill; Gamma Knife.
Radiological Society of North America. Side effects. Acoustic Neuroma Association. Accessed July 31, Support group overview. Accessed Nov. Mayo Clinic, Rochester, Minn. July 31, Louis ED, et al. Acoustic neuroma and other skull base tumors. In: Merritt's Neurology. Wolters Kluwer; Proton therapy. American Brain Tumor Association.
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