Also referred to as ‘vestibular schwannoma’, acoustic neuroma is simply a slow-growing tumor that is non-cancerous in nature. Vestibular schwannoma grows due to formation and multiplication of Schwann cells that are present around nerve fibers of inner ears and interconnected to brain an individual. As acoustic neuroma advances, it presses the nerve fibers that eventually affect hearing as well as balancing ability of patients. People encountering hearing problems or unsteadiness from a long time should consult experienced neurosurgeons for precise diagnosis. Timely treatment of vestibular schwannoma can considerably help patients in attaining a better quality of life.
Types of Acoustic Neuromas
The following are the two major types of acoustic neuromas or vestibular schwannomas.
- Unilateral Vestibular Schwannomas – Unilateral vestibular schwannomas refer to the type of tumors that affects only a single ear. Such types of tumors are observed more often in people belonging to age category of 30 to 60 years. There is no scientific evidence that can clearly state the reason behind occurrence of unilateral vestibular schwannoma. However, medical experts believe that nerve damage caused due to environmental factors may lead to such unfortunate health condition.
- Bilateral Vestibular Schwannomas – Bilateral vestibular schwannomas occur due to a genetic problem called as neurofibromatosis type – 2. These type of tumors are known to create immense pressure on nerve fibers and negatively affect both the ears of patients.
Causes and Risk Factors for Acoustic Neuroma
There is no specific cause that can confirm what causes the condition of acoustic neuroma. However, healthcare professionals state that it mainly appears due to genetic malfunctioning. Apart from that, acoustic neuroma may come into existence due to the following factors.
- Overexposure to Loud Noise – Continuous and long-term exposure to loud noise may lead to development of acoustic neuroma in people.
- Previous Radiation Treatments – Patients who had undergone radiation treatments especially for neck or face-related health issues in the past have a greater likelihood of developing acoustic neuroma.
- Neurofibromatosis Type 2 – People who have a family history of ailments such as neurofibromatosis type -2 are more prone to getting vestibular schwannomas as compared to others.
Signs and Symptoms of Acoustic Neuroma
The given list describes some of the major signs and symptoms that patients with underlying acoustic neuroma condition may encounter.
- Hearing Loss – Patients with acoustic neuroma may have to face hearing loss that may appear either suddenly or develop gradually over a period.
- Tinnitus – Problem of ringing of ears or tinnitus may affect an ear or both the ears of patients due to an unrecognized acoustic neuroma condition.
- Balancing Issues – Patients struggling with acoustic neuroma are likely to encounter balancing issues. They must seek medical assistance before it begins to interfere with their routine life.
- Dizziness and Headaches – Dizziness and frequently occurring headaches are the most prominent symptoms of acoustic neuroma.
- Facial Numbness – Facial numbness or paralysis on one side of face could be a potential warning sign of acoustic neuroma tumor. Patients should not ignore such problems and seek prompt medical help for ensuring sound health status.
Diagnosing Acoustic Neuroma
At first, patients who are battling with above-mentioned signs of acoustic neuroma should start looking for a well-versed and experienced neurosurgeon who have expertise in handling such cases. During medical consultation, doctors may ask patients regarding their problems as well as their previous medical history. They may request patients to submit their reports so that they can thoroughly analyze their internal state of being. If respective neurosurgeons suspect problem of acoustic neuroma, they may order the given tests for confirmation.
- Hearing Evaluation (Audiometry) – During audiometry test, patients will be asked to sit comfortably and wear earphones. These earphones are connected to a sophisticated hearing machine that captures the response of patients as they hear various sounds and speech. Respective doctors may increase the volume or minimize it to extremely low level in order to understand the actual hearing capability of patients.
- Brainstem Auditory Evoked Response (BAER) – BAER test precisely measures brain wave activity of patients. Patients may be asked to wear electrodes on scalp and earlobes that are capable of measuring their brain’s response with respect to any sound or tone. Doctors will check the obtained reports for confirming the presence of any abnormality.
- Imaging Tests – Patients may have to undergo certain painless imaging tests like magnetic resonance imaging (MRI scan) or computerized tomography (CT scan) if other tests hint that patients may have an acoustic neuroma. Magnetic resonance imaging test involves generation of high-quality images of patient’s entire brain area with the help of radio frequency waves and highly effective magnetic fields. Patients may be asked to lie comfortably inside a machine which will scan the desired internal body organs. In some instances, doctors may use computerized tomography scan (CT scan) that uses x-rays for serving the purpose of identification of acoustic neuroma. Similar to MRI scan, it is also a painless imaging procedure.
Doctors will determine the best suitable acoustic neuroma treatment plan based on the inspection reports. They may ask patients to make some lifestyle changes before undergoing any medical treatment such as avoiding loud noise and hearing music at high volume especially if they are using earphones. Patients must follow these instructions to avoid further nerve damage during pre-operative period.
Treatment Options for Acoustic Neuroma
Treatment for acoustic neuroma may vary with respect to size of tumor, patient’s age, and overall health. Extremely slow growing acoustic neuroma tumors do not need any special treatment. Doctors may ask patients to undergo certain tests at regular intervals in order to monitor their condition. For other large or rapid growing tumors, a prompt treatment is necessary. The following points depict three main treatment options for acoustic neuroma.
- Acoustic Neuroma Surgery – Acoustic neuroma surgery is the mainstream treatment for prominent tumors. Its main objective is to reduce the likelihood of serious hearing problems and facial nerve damage. During acoustic neuroma surgery, patients will be sedated by using general anesthesia. General anesthesia helps them sleep throughout the operation that significantly minimizes the risk of pain and uneasiness. Respective neurosurgeons carefully make an incision or cut in skull region to reach brain of patients. Once they reach the proper location, they remove the trouble-causing acoustic neuroma tumor and close the incision. Doctors may also perform acoustic neuroma surgery by making an incision in back end of affected ear. However, such minimally invasive approach may not be suitable for everyone. Doctors will choose type of acoustic neuroma surgery based on health requirements of patients.
- Gamma Knife Stereotactic Radiosurgery for Acoustic Neuroma – Acoustic neuroma Gamma Knife stereotactic radiosurgery is a simple yet highly advanced medical intervention that can noticeably treat small to medium acoustic neuromas. This treatment involves use of multiple sharp and focused gamma rays in order to destroy the tumor. Respective doctors use 3 dimensional or 3D imaging scans in order to figure out the exact tumor location before beginning the acoustic neuroma Gamma Knife stereotactic radiosurgery After that, patient’s head is numbed with the help of essential medicines and headframe is used to retain healthy tissues around tumor and preserve facial nerves. Once everything is done, doctors ask patients to lie in a still position in front of device that emits required dosage of radiation and target the tumor with a high degree of precision.
- Fractionated Stereotactic Radiotherapy for Acoustic Neuroma – Fractionated stereotactic radiotherapy for acoustic neuroma (FSRT) is a type of stereotactic radiation treatment that is given to patients in a number of fractions over several days. Respective doctors give small doses every time so as to save the healthy tissues surrounding acoustic neuroma. Patients may need to undergo fractionated stereotactic radiotherapy for acoustic neuroma five days a week followed by a rest period. The main concept behind giving radiation in multiple fractions is to give time to the tissues for repairing in between the treatment. It considerably reduces the chances of serious side-effects.
- Proton Beam Therapy for Acoustic Neuroma – As the name itself conveys, proton beam therapy for acoustic neuroma involves the use of energized beams of protons to kill the cells that contribute to the formation of acoustic neuroma tumor. Unlike other radiation therapies, proton therapy releases energy on specific target and stops automatically once the dosage is completed. It clearly reduces the risks of damage to healthy tissues surrounding acoustic neuroma tumor. During proton therapy, patients are exposed to a device called as ‘particle accelerator’ that emits a beam of positively charged sharp protons to fulfill the purpose.
Risks and Complications Associated with Treatments for Acoustic Neuroma
The below points elaborate potential risks and complications associated with different treatments for acoustic neuroma.
- Acoustic Neuroma Surgery – Clotting of blood, infection or wound in skull, swelling, seizures, muscle weakness, and balancing problems are the main risks associated with acoustic neuroma surgery.
- Gamma Knife Stereotactic Radiosurgery for Acoustic Neuroma – Acoustic neuroma Gamma Knife stereotactic radiosurgery may result in complications like extreme tiredness, nausea, headaches, swelling, redness, and irritation in scalp.
- Fractionated Stereotactic Radiotherapy for Acoustic Neuroma – Patients who have undergone acoustic neuroma fractionated stereotactic radiotherapy may have to encounter complications like nausea, hair loss, sensitivity, and irritation in head and fatigue.
- Proton Beam Therapy for Acoustic Neuroma – Although acoustic neuroma proton beam therapy is a safe procedure, it may lead to problems like mouth sores, digestive issues, skin redness, and sores around head.
Recovery Following Acoustic Neuroma Treatment
Recovery will vary according to the particular type of acoustic neuroma treatment. Patients will need to keep patience and follow each and every instruction of respective neurosurgeon for ensuring long-term outcomes. They may be asked to make dietary changes for regaining their lost body strength. Above all, patients should maintain follow-up sessions by visiting neurosurgeons at regular time intervals. It will definitely aid a smooth and faster recovery.
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