Benign tumours of the Schwann cells surrounding the auditory nerve - also called vestibular schwannoma
Found in the peripheral nervous system and provide the myelin sheath around the neurones
Acoustic neuromas are usually unilateral. Bilateral acoustic neuromas are associated with neurofibromatosis type II.
Causes/Factors
- Sporadic
- Neurofibromatosis type II
Symptoms
- Hearing loss - gradual/progressive unilateral sensorineural hearing loss often in high frequency sounds first
- Dizziness or imbalance
- A sensation of fullness in the ear
- Facial numbness/tingling - due to compression of the trigeminal nerve
Signs
- Hearing loss - with preserved speech discrimination
- Abnormal vestibular function
- Facial weakness - compression of the facial nerve
- Tympanic membrane abnormalities
Investigations
- Audiometry - sensorineural pattern of hearing loss
- Brain imaging - MRI to look for tumour
Management
- Conservative - monitor if there are no symptoms or treatments
- Surgery to remove the tumour - partial or total
- Radiotherapy
Complications/red Flags
- Vestibulocochlear nerve injury - permanent hearing loss of dizziness
- Facial nerve injury with facial weakness