Acoustic neuromas

Acoustic neuromas are also known as "schwannomas" because they arise from Schwann cells, which are the cells that line nerves. "Acoustic" indicates that the tumour forms on the eighth cranial nerve, called the acoustic nerve because its function is involved with hearing. The hearing nerve is also involved with balance and is also very close to the nerve that controls the muscles of the face. Thus these tumours generally come to medical attention because of progressive hearing loss or deafness, affecting one ear. Both men and women are affected and they can occur at all ages.

Acoustic neuromas are benign, grow slowly over many years, but if left alone they can cause complete deafness, or even more serious effects if they become very large.

These tumours are generally diagnosed on an MRI scan. If an acoustic neuroma is suspected, you will need to have a formal hearing test and balance test and will also see an ENT (Ear, Nost and Throat) Surgeon who specialises in conditions affecting the ear and hearing. A CT scan may also be ordered before any surgery or treatment.

Treatment of these tumours can take one of three pathways: (1) Surgery, (2) Radiation therapy, or (3) watching and waiting.

Surgery to remove the tumour if possible, is often the best option and has a high chance of curing the tumour in the long term. The operation is performed by the neurosurgeon and the ENT surgeon operating together. There are various options in terms of the surgical approach and this will be discussed in detail with you by both surgeons at your consultations. If some cases it is possible to save the remaining hearing function that the patient has, but sometimes it is not possible. The operation requires around 5 to 7 days stay in hospital.

Radiation, usually given as a single-dose treatment ("radiosurgery") can be an excellent option for smaller tumours, can be done as an outpatient, and avoids the need for an open incision and other risks associated with surgery. However, the long term results are not absolutely known at the present time, although they are promising in terms of stopping the growth of the tumour for at least 10 years.

Watching and waiting with follow up MRI scans is an option if neither of the previous 2 options are approprite. Your surgeon will discuss all the above options with you.