Acoustic Neuroma

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An acoustic neuroma (vestibular schwannoma) is a slow growing tumor on the nerve leading from the brainstem to the ear. This nerve plays a role in hearing and in maintaining your balance. It is a benign tumor, which means it is not cancerous. However, this condition can still cause serious problems.

Factors that may increase your chance of an acoustic neuroma include:

  • Age: 30-60
  • History of neurofibromatosis type 2 (NF2)
  • Family history of NF2

Acoustic Neuroma Symptoms

The first symptoms of an acoustic neuroma include:

  • Gradual hearing loss in one ear with near normal hearing in the other ear
  • Decrease in sound discrimination, especially when talking on the telephone
  • Ringing in the affected ear, called tinnitus
  • As the neuroma gradually grows larger, symptoms may include:
    • Balance problems
    • Facial numbness and tingling
    • Weakness of the facial muscles on the side of the tumor

If headaches or mental confusion occurs, the tumor may be life-threatening. Call your doctor right away.

Acoustic Neuroma Diagnosis & Treatment

Images may be taken of your head with:

  • MRI scan
  • CT scan

Tests may be done on your ears. These may include:

  • Audiogram
  • Auditory brainstem response test
  • Electronystagmography


The size of the tumor and level of hearing in the affected ear will determine the type of operation you’ll need. As the tumor grows larger, surgery becomes more difficult because the tumor may have thinned out the nerves that control facial movement, hearing, and balance and may also have affected other nerves and structures of the brain.

Surgery offers immediate treatment but higher risks, including:

  • Cerebrospinal fluid leak (5% to 17% risk)
  • Meningitis
  • Hydrocephalus
  • Wound infection

Other common effects include a period of headaches or balance difficulties or facial weakness. These risks increase with tumor size and the type of surgical procedure performed.

Gamma Knife 

The goal of Gamma Knife radiosurgery on acoustic neuromas is to control tumor growth. The risks of radiosurgery are less than those for regular surgery. 


For elderly or frail patients with slow-growing acoustic neuromas, observation may be preferable to surgery.

Those with smaller tumors may also decide to get frequent MRIs and audiograms. In this situation, treatment can be postponed until tumor growth is confirmed or symptoms worsen.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.