Do you also feel like your hearing in one ear is gradually decreasing? Or do you constantly hear a 'C' sound (tinnitus) in your ear? Do you sometimes lose your balance and feel dizzy? Many people dismiss these things as "normal things that happen as you get older." But these can also be the first symptoms of a condition called Acoustic Neuroma, which we are talking about today. Don't worry, we will talk about everything clearly.
Simply put, what is Acoustic Neuroma?
Acoustic Neuroma, also known as Vestibular Schwannoma, is not cancer . It is a non-cancerous tumor that develops on the eighth cranial nerve, which connects our brain and inner ear.
Think of this nerve as a 'cable' that carries information to our brain and ears. It has two main parts.
1. The part that transmits sound: This part carries the sounds we hear to the brain.
2. The part that controls balance: This part sends information about our body's balance from the inner ear to the brain.
Acoustic Neuroma is a tumor that grows on the nerve. These tumors usually grow very slowly, over many years . Although they do not spread to the brain like cancer, as the tumor grows, it can put pressure on the brain and surrounding nerves. For example, it can put pressure on the nerves that control facial expressions and sensations. If the tumor gets very large, it can press on the brain stem or cerebellum, which can be life-threatening. So it is important to be aware of this.
What are the symptoms of this condition?
The early symptoms of this condition are subtle, making it difficult to recognize. Often, the first symptom is a gradual loss of hearing in one ear . This may be accompanied by a ringing sound (tinnitus) or a feeling of fullness in the ear. Very rarely, sudden loss of hearing can occur.
Other symptoms that may appear over time are listed in the table below.
| Symptom | How it happens |
|---|---|
| Balance problems | Staggering, such as when walking, difficulty staying steady. |
| Vertigo | Feeling as if you or the world is spinning around you. |
| Facial numbness and tingling | This situation may persist or come and go. |
| Facial weakness | Feeling like one side of the face is being pulled or loss of muscle control. |
| Taste changes | Feeling different than if the food tastes different. |
| Difficulty swallowing and hoarseness | Difficulty swallowing food and drink and changes in voice. |
| Headaches | Frequent, unrelenting headaches. |
| Unsteadiness and Clumsiness | Difficulty performing tasks, loss of limb control. |
| Confusion | Problems with memory and clarity of thought. |
The most important thing is that if you have these symptoms, you should definitely see your doctor. Symptoms such as clumsiness and confusion, in particular, can be a sign of a serious condition that requires emergency treatment. In such a case, it is wise to immediately go to a hospital's Emergency Treatment Unit (ETU).
What causes these tumors to form?
There are two main types of acoustic neuroma.
1. Sporadic form: This is the type that most people develop. Doctors have not yet found a specific cause for this.
2. How it is related to Neurofibromatosis type II (NF2): NF2 is a rare genetic condition. People with this condition develop non-cancerous tumors in the nervous system of the body. Acoustic Neuroma is the most common type of tumor. People with NF2 often develop these tumors in both ears by the age of 30.
However, only 5% of acoustic neuroma patients have NF2. That means 95% of them are the idiopathic type. The only known risk factor for this is exposure to high doses of radiation to the head and neck .
What are the treatment options?
There are three main treatments for this.
1. Observation: This is also called 'watchful waiting'. Since acoustic neuromas are not cancerous and can grow very slowly, treatment may not be necessary right away. Your doctor will monitor the growth of the tumor with tests such as MRI scans at regular intervals. Only if the tumor is growing rapidly or if serious symptoms occur will other treatments be considered.
2. Surgery: Surgery can remove all or part of the tumor. There are three main surgical approaches for this.
| Surgical approach | How to and important information |
|---|---|
| Translabyrinthine | An incision is made behind the ear, and the bone behind the ear and part of the middle ear are removed to reach the tumor. This is used for tumors larger than 3 centimeters. Advantage: The surgeon can clearly see the facial nerve. Disadvantage: After this surgery, hearing in that ear is completely lost. |
| Retrosigmoid/sub-occipital | The skull is opened at the back of the head to reach the back of the tumor. This can be used for tumors of any size and has the potential to preserve hearing . |
| Middle fossa | A small piece of bone above the ear canal is removed to reach the tumor. This is used for small tumors that are confined to the small passageway leading to the inner ear (internal auditory canal). This method also has a higher chance of preserving hearing . |
3. Radiation Therapy: Radiation therapy is sometimes recommended. With modern technology, high doses of radiation can be delivered to the tumor while minimizing damage to surrounding healthy tissue. This treatment causes the tumor cells to die. This can stop the tumor from growing, shrink it, or even make it smaller. However, it does not completely remove the tumor like surgery can.
There are two main ways in which radiation therapy is given:
- Single fraction stereotactic radiosurgery (SRS): In a single session, hundreds of small beams of radiation are aimed at the tumor.
- Multi-session fractionated stereotactic radiotherapy (FRS): Small doses of radiation are given daily over several weeks. Preliminary studies suggest that this method is more likely to preserve hearing than SRS.
Both of these treatments are outpatient treatments, meaning you don't need to stay in the hospital.
How do you choose the right treatment for you?
The decision about which treatment is best for you will depend on several factors.
- The size of the tumor.
- Whether the tumor is growing.
- your age.
- Other illnesses you have.
- The severity of your symptoms and how they affect your daily life.
Your doctor will explain all of this to you.
Take-Home Message
- Acoustic Neuroma is not cancer, but it can grow and affect the brain and surrounding nerves.
- Don't ignore early symptoms like gradual hearing loss in one ear, ringing in the ear, or loss of balance. Don't assume that "things happen as you get older."
- If you have any of these symptoms, seek medical advice immediately, preferably from an ear, nose, and throat (ENT) surgeon.
- There are effective treatments such as observation, surgery, and radiation therapy.
- Discuss the best treatment for your condition with your doctor, understand the pros and cons, and decide.
💬 Comments (0)
No comments have been posted yet. Add your comment here for the first time.
Add your comment