Hearing loss, especially if it happens over time, can have lots of causes. But hearing loss along with balance issues and face numbness could be a sign of an acoustic neuroma (also called a vestibular schwannoma).
An acoustic neuroma is a type of ear tumor. The tumor grows on the nerve leading from your brain to your ear. This nerve helps with your hearing and helps you maintain your balance.
Acoustic neuromas are benign tumors, which means they aren't cancerous. However, acoustic neuromas can still cause serious problems.
Acoustic Neuroma Treatment at UVA Health
There are a few ways to treat an acoustic neuroma.
Watching your acoustic neuroma to see if it changes might be your first step. We might start here if your tumor isn’t causing symptoms, is only growing slowly, or you aren’t a good candidate for surgery. If this is the case, you'll have regular imaging to see if the tumor changes.
Surgery can remove acoustic neuromas. We usually choose surgery if the tumor is growing or is causing symptoms.
The size of the tumor and amount of hearing loss determines the type of surgery you'll need. As acoustic neuromas get larger, surgery becomes more difficult because they can affect nerves that control your facial movement, hearing, and balance. The tumor may also affect other nerves or other parts of your brain.
Risks of having acoustic neuroma surgery include:
- Wound infection
- Cerebrospinal fluid leak
Because the tumor affects your nerves, you may still have some symptoms after it's removed, like facial numbness or hearing loss. You may also have headaches, balance difficulties, or facial weakness for a short time after surgery. These risks increase with tumor size and the type of surgery that is done.
Gamma Knife radiosurgery is used on acoustic neuromas to control tumor growth. It can keep the tumor from growing larger and causing symptoms to get worse.
The risks of radiosurgery are less than those of regular surgery.
Acoustic Neuroma Symptoms
You're more likely to develop an acoustic neuroma if you:
- Are between ages 30 and 60
- Have a history of neurofibromatosis type 2 (NF2) or have NF2 in your family
Symptoms of an acoustic neuroma include:
- Hearing loss in one ear (with normal hearing on the other side); usually gradual but may be sudden
- Lowered ability to distinguish between different sounds, especially when talking on the telephone
- Ringing in one ear (tinnitus)
As the neuroma gradually grows larger, symptoms may include:
- Balance problems
- Facial numbness and tingling
- Weakness in the face muscles on the same side as the tumor
If you have headaches or mental confusion, the tumor may be causing a life-threatening condition. Call your doctor right away.
Diagnosing Acoustic Neuromas
To check if you have an ear tumor, we'll take images of your head with:
- MRI scan
- CT scan
We'll also tests your ears using:
- Audiogram (a test that measures how well you can hear soft sounds)
- Auditory brainstem response test (a test that measures your brain's response to signals from your ears)
- Electronystagmography (a test that measures electrical activity in your eye)