What is an acoustic neuroma and why is it dangerous?

Acoustic neuroma (also called vestibular or acoustic schwannoma) is a benign tumor that is formed from Schwann cells of the auditory nerve or the eighth pair of cranial nerves. This pathology accounts for 11-13% of all intracranial tumors. It is mainly diagnosed in adults aged 30-50 years, more often in women. This benign formation grows quite slowly. However, the tumor can reach significant sizes, lead to hearing impairment, problems with balance, in some cases – mental disorders, paralysis of facial muscles, it can also put pressure on important structures and even be life-threatening.

However, modern medicine offers effective treatment for acoustic neuroma. For this purpose, leading neurosurgery clinics use minimally invasive microsurgical methods and radiation therapy, which makes it possible to stop the growth or remove the tumor, eliminate symptoms and return patients to a normal quality of life.

The MedTour platform will help you choose a medical center where specialists will select for you the optimal method of treating neuroma, most suitable for your indications, and will help you effectively solve this health problem.

Causes of acoustic neuroma

At the moment, the exact reasons for the formation of acoustic neuroma are unknown. However, there are a number of factors and reasons that contribute to the appearance of neoplasms of this type. They often occur when a person has neurofibromatosis type 2. This is a hereditary pathology in which benign neoplasms arise from nerve sheaths in different parts of the body. Acoustic schwannoma is also associated with the occurrence of mutations on chromosome 22.

In addition, factors that can increase the likelihood of this tumor include: exposure to radiation, exposure to toxic substances, and traumatic nerve damage.

What does an acoustic neuroma look like?

Detailed and clear MRI images make it possible to examine the tumor of the auditory nerve and see that it usually has a round shape and smooth, clearly defined edges. It can be described as a fairly tight knot. If the neuroma is large enough, it can put pressure on the cerebellum or brain stem, deforming it.

Symptoms of acoustic neuroma

The most common symptoms of vestibular schwannoma include:

• Hearing impairment. As the auditory nerve tumor grows and presses on nearby tissue, the symptom progresses. Over time, deafness may develop in the ear on which the tumor appeared.
• Tinnitus. It is also one of the most common symptoms of neuroma.
• Dizziness, problems with coordination of movements, nausea. These signs are associated with disturbances in the functioning of the vestibular system.
• Ear pain, ear congestion.
• Taste disturbances.
• Numbness of a part of the face, weakening of the facial muscles, visual asymmetry.

If there is a tumor of the auditory nerve, the signs intensify as it grows and puts pressure on surrounding structures. In addition, symptoms may differ slightly depending on the location of the tumor relative to the brain stem and depending on its type.

Types of acoustic neuroma

Neoplasms of this type can be of several types:

• One-sided. Diagnosed in 90% of cases.
• Double-sided. A prerequisite for their appearance is hereditary neurofibromatosis.

In addition, based on localization, doctors distinguish between medial and lateral tumors.

• Medial schwannoma. It is diagnosed in the angle of the cerebellar pons. A large number of cranial nerves pass through this area. Accordingly, the formation begins to put pressure on them, which causes the appearance of characteristic symptoms.
• Lateral tumor. It is found in the internal auditory canal. In this area, the tumor can put pressure on the auditory or facial nerve, or the chorda tympani. Symptoms may vary somewhat depending on which nerve is suffering from the pressure of the formation.

Stages of acoustic neuroma

• First stage. It is diagnosed when the tumor grows to 2-2.5 centimeters. At this stage, hearing loss appears. Facial numbness, taste changes, and coordination may also deteriorate.
• Second stage. The tumor reaches sizes up to 3.5 centimeters. Symptoms get worse. Complete hearing loss may occur from the location of the tumor, and coordination of movements is noticeably impaired. Nystagmus of the oculomotor nerves and changes in the human psyche may occur.
• Third stage. Acoustic schwannoma reaches four or more centimeters. There is strong pressure on the brain stem. Severe headaches are a concern, nausea, vomiting, vision problems, disturbances of consciousness, and psychosis are possible. The threat of death occurs if the nerves responsible for breathing processes are compressed.

Diagnosis of acoustic neuroma

For acoustic neuroma, diagnosis includes a complex of methods. The examination may include the following methods:

• audiometry;
• MRI or CT with contrast;
• electrocochleography;
• otoscopy;
• electronystagmography;
• neuromyography;
• vestibulometry (videonistagmography) ;
• brainstem audiometry.

A comprehensive study determines the size of the tumor, its location, and to determine how much it affects hearing, the vestibular system, and which nerves are under pressure.

Acoustic neuroma: MRI diagnosis

MRI is one of the most important diagnostic methods, which is used when a neuroma is suspected to visualize the tumor. Magnetic resonance imaging makes it possible to detect even small tumors in the first stages. It is possible to accurately calculate the size and location of the neuroma. This method also makes it possible to see the structure of the tumor and identify which tissues it puts pressure on (cerebellum, nerves, brain stem, bone structures). CT can also provide similar information in case of acoustic neuroma.

Treatment of the auditory nerve with neuroma

If a neuroma is diagnosed, doctors choose treatment tactics depending on the characteristics of the tumor, the symptoms it gives, and the characteristics of a patient’s health.

• Observation. Watchful waiting is usually appropriate for small tumors that do not produce symptoms and are discovered incidentally. Neuromas can grow very slowly or stop growing at a certain point, then observation tactics are sufficient. In this case, a patient is recommended to undergo regular examinations and monitor the growth dynamics of the tumor.
• Radiation therapy. The use of radiation therapy makes it possible to stop the growth of a tumor by irradiating it. Radiation is prescribed first if surgery is not recommended for some reason or if the tumor needs to be reduced before surgery. In modern clinics, IMRT radiation therapy is usually used, which makes it possible to precisely regulate the radiation zone and the intensity of radiation therapy.
• Cyberknife. This is a radiosurgical method that can be recommended for tumors smaller than 3 centimeters. In this case, irradiation is performed in single, higher doses with great precision, which leads to the destruction of the neuroma.
• Operation. Surgery may involve complete removal of the schwannoma and be a stand-alone method, or it may be used in conjunction with radiation therapy. Surgical treatment allows the tumor to be completely removed in more than 95% of cases.

How is surgery to remove an acoustic neuroma performed?

Surgery for the diagnosis of acoustic neuroma is performed under general anesthesia. To gain access to the area where the tumor is located, a surgeon makes a small hole in the skull. Today, preference is given to minimally invasive techniques using microscopes and endoscopes. This makes it possible to remove the acoustic neuroma with maximum precision, clearly separating healthy tissue from the neoplasm. The use of neuronavigation also makes it possible to increase the accuracy of all surgical procedures and avoid damage to important structures.

This type of surgery is easier to tolerate and does not leave rough scars. Already 5 days after surgery, a person can leave the clinic.

Recurrence of acoustic neuroma is a fairly rare occurrence. However, sometimes the tumor may begin to grow again. Therefore, after surgery, it is recommended to periodically undergo MRI examinations.

How long does surgery to remove an acoustic neuroma take?

The duration of such operations depends on the size of the neuroma, the characteristics of access to it and the methods of removal. Small neuromas that are easy for the surgeon to reach are usually removed within 1 hour. It may take 2-3 hours to remove large tumors and tumors located in hard-to-reach places.

Removal of acoustic neuroma – cost of surgery

Prices for surgery will vary markedly depending on the country in which you have it done. So, for example, in Turkey the price will be from 15 thousand dollars, in Spain – from 18 thousand euros, in Germany – from 20 thousand euros. In addition, pricing will be influenced by: the level of the clinic you choose, the removal technique, the volume of the operation, its complexity, and the qualifications of the surgeon.

You can find out prices for neuroma removal in different countries and clinics from the MedTour coordinating doctor. The medical coordinator will familiarize you with the cost of surgical procedures and tell you about the doctors who perform such operations.

Rehabilitation after surgery for acoustic neuroma

After the surgeon removes the tumor, it may take about a month to recover. Rehabilitation may include drug therapy and physical therapy. Your doctor may recommend special exercises to train the vestibular system. It will also be necessary to adjust your diet for some time.

Attentive attention to the doctor’s recommendations will help you go through the recovery period faster and maintain normal health.

Why is acoustic neuroma dangerous? Mortality in cases of acoustic neuroma

Despite the fact that this is a benign formation, which, as a rule, grows slowly, the pathology still carries quite serious health risks.

It is rarely diagnosed in the early stages. Moreover, in the later stages of development, the neoplasm can lead to deafness, paralysis of facial muscles, hydrocephalus, the inability to chew food independently and other dangerous complications, including death. Therefore, when an acoustic schwannoma is detected, it is very important to consult a doctor and select adequate treatment.

Acoustic neuroma – prognosis

If the tumor is detected on time, is under the supervision of specialists, or is adequately treated, the prognosis is favorable. Modern medical approaches to this disease make it possible to take control of the condition, eliminate symptoms and normalize well-being.

The best clinics for the treatment of the auditory nerve

Are you looking for which clinic to go to for acoustic schwannoma? Today you have the opportunity to take advantage of the most modern methods of diagnosis and treatment of neuromas in the best medical centers.

The MedTour platform cooperates with the most advanced clinics that successfully treat this disease. We will help you choose a clinic for the treatment of acoustic neuroma in Ukraine, Turkey, Italy, Israel, South Korea, Germany and other countries of the world. The MedTour coordinator will tell you in detail about the most suitable medical institutions, treatment methods in each of them, and leading specialists in this field.

Which doctor treats acoustic neuroma?

Otolaryngologists and neurologists treat this pathology. In order to choose the most suitable treatment for your condition, you need to find a specialist with the necessary qualifications.

MedTour cooperates with leading neurologists and otolaryngologists from around the world. Our coordinating doctor will advise you on all issues free of charge and help you choose a good doctor according to your requests and needs. To get the necessary information and assistance, send us a request via the contact form or call the numbers listed on the website.

Published: 19.04.2024

Updated: 20.04.2024

Medical author, Medical editor:

Natalia Segen

Medical author, Medical editor:

Olena Kursabaieva