Acoustic Schwannomas

At a glance

Symptoms: One-sided hearing loss, tinnitus, and unsteadiness
Common causes: Usually no known cause; tumors on both sides occur in neurofibromatosis type 2
How it's diagnosed: MRI with contrast, hearing tests, and vestibular testing
Treatment: Monitoring with MRI, radiosurgery, or surgical removal

Overview

Acoustic Schwannomas, or vestibular schwannomas, are non-cancerous tumors that develop on the cranial nerve leading from the inner ear to the brain. This nerve is responsible for balance and hearing, making the location of these tumors particularly significant for sensory function.

Symptoms

Hearing Loss: Typically unilateral, affecting one ear.
Tinnitus: Persistent ringing or buzzing in the affected ear.
Balance Issues: Difficulty maintaining balance due to the tumor’s impact on vestibular functions.
Facial Numbness: In advanced cases, the tumor may affect facial nerves.

Diagnosis

MRI Scans: Essential for visualizing the size and location of the tumor.
Audiometric Tests: Assess the extent of hearing loss.
Vestibular Tests: Including VNG (Videonystagmography) to evaluate balance function.

Treatment

Observation: Monitoring the growth of smaller tumors with regular imaging.
Stereotactic Radiosurgery: A non-invasive method using focused radiation to reduce the size of the tumor or stop its growth.
Surgical Removal: Recommended if the tumor causes significant symptoms or continues to grow. This procedure aims to preserve as much nerve function as possible.

At our clinic

CDP (Computerized Dynamic Posturography): Assesses how well you can maintain balance and posture.
EEG (Electroencephalogram): Although primarily used for brain activity, EEG can help rule out other neurological conditions.
EMG/NCV (Electromyography and Nerve Conduction Velocity): Tests nerve and muscle function which might be indirectly affected by large tumors.
Epley Omniax Chair and TRV Chair: Used for precise diagnosis and treatment of positional vertigo when clinically appropriate.
Tilt Test: Helps determine how your body responds to changes in position, influenced by inner ear and brain functions.
Vertigo Recording Goggles: Track eye movements to diagnose causes of vertigo linked to inner ear conditions, including schwannomas.

Living with Acoustic Schwannomas:Management strategies focus on maintaining quality of life through:

Hearing Aids: For patients experiencing hearing loss.
Vestibular Rehabilitation: To improve balance.
Support Services: Counseling and support groups for patients and families.

Testing that can help

Testing is chosen from your history and examination. These are the tests most often used here.

Videonystagmography (VNG)A comprehensive eye-movement test battery used to evaluate vestibular and oculomotor function.

Vestibular Evoked Myogenic Potentials (VEMP)Measures reflex responses from the otolith organs (saccule and utricle) to sound or vibration.

Specialty care: Hearing LossHearing loss can result from damage to different parts of the ear, including the outer, middle, and inner ear, as well as the pathways that lead to the brain.TinnitusTinnitus is ringing, buzzing, or other sound in the ears with no outside source. It often accompanies hearing loss and can be managed even when it can't be cured.Meniere's DiseaseMeniere's disease is an inner ear disorder that causes attacks of vertigo along with fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear.The Inner EarThe inner ear holds the cochlea for hearing and the vestibular organs for balance, which sense head rotation, gravity, and movement.

When to seek urgent care

Call 911 or go to the nearest emergency department if dizziness or imbalance starts suddenly together with any of the following, since these can be signs of a stroke or another emergency:

Weakness or numbness of the face, arm, or leg, especially on one side
Trouble speaking or understanding speech
Double vision or sudden loss of vision
A sudden, severe headache
Inability to walk or stand
Chest pain, fainting, or a seizure