Acoustic neuroma is a benign tumor that grows on the nerve connecting the ear and brain. Pthis disease characterized by the appearance of symptoms, such as ear ringing (tinnitus), vertigo, and hearing loss.
Acoustic neuroma is also known as vestibular schwannoma. This benign brain tumor grows slowly on the nerves that regulate hearing and balance. As a result, slowly acoustic neuroma sufferers will experience impaired hearing function and balance disorders.
Acoustic neuromas do not spread to other parts of the body, but in rare cases, the growth of an acoustic neuroma can compress the brainstem and interfere with brain function.
Causes of Acoustic Neuroma
The exact cause of acoustic neuroma is not known. Acoustic neuroma occurs when a gene on chromosome 22 does not function normally. This gene on chromosome 22 functions to control the growth of Schwann cells, which are cells that surround nerve cells in the body, including nerves that regulate balance.
This condition causes Schwann cells to grow and develop uncontrollably. One of the diseases that is often associated with acoustic neuroma is neurofibromatosis type 2. This disease is a genetic disorder characterized by tumor growth in various nerve tissues.
Acoustic Neuroma Risk Factors
There are several factors that can increase a person's risk of suffering from an acoustic neuroma, namely:
- Have parents who suffer from neurofibromatosis 2
- Suffering from parathyroid neuroma
- Have a history of treatment with previous radiotherapy
- Experiencing continuous exposure to noise
Acoustic neuromas are also more commonly found and diagnosed in middle age, around the age of 30–50 years.
Symptoms of Acoustic Neuroma
Symptoms of an acoustic neuroma depend on the size of the tumor. If the tumor is small, the patient usually does not experience any symptoms. New symptoms appear when the tumor is large enough to press on the nerves that control hearing and balance.
Acoustic neuroma tumor growths can also press on nerves, blood vessels, or other structures in the face or in the brain. If the tumor has suppressed these structures, symptoms will appear in the form of:
- Hearing loss, usually in one ear
- Ringing in the ears (tinnitus)
- Balance disorders
- Vertigo
As the acoustic neuroma grows in size, other symptoms may appear, including:
- Constant headaches
- Hoarseness or difficulty swallowing
- Impaired limb coordination (ataxia)
- Double or blurred vision
- Pain or numbness on one side of the face
- drooping face
When to go to the doctor
Immediately see a doctor if you experience ringing in the ears, loss of hearing in one ear, or balance problems. Early diagnosis and treatment can prevent complications.
Acoustic Neuroma Diagnosis
The doctor will ask the patient's complaints and symptoms. Next, the doctor will examine the patient's ear. One way is to use an otoscope to view the patient's ear canal and middle ear.
To confirm the diagnosis, the doctor will perform further tests, such as:
- Hearing tests, including audiometry, tuning fork tests, and auditory brain stem response test
- Electronystagmography, to detect balance disorders through eyeball movements
- Scans with CT scans and MRIs, to see the location and size of the tumor
Acoustic Neuroma Treatment
Treatment of an acoustic neuroma depends on the size and speed of the tumor's growth, as well as the patient's health condition. The handling methods consist of:
Observation
For acoustic neuroma tumors that are small, slow growing, and asymptomatic, the doctor will perform regular observations and hearing tests or scans. This examination is usually done every 6 months to 1 year. The goal is to monitor tumor growth.
If the tumor enlarges or shows symptoms that are getting worse, the doctor will take additional measures.
Stereotactic radiosurgery
Stereotactic radiosurgery performed on acoustic neuromas aims to stop tumor growth. Stereotactic radiosurgery performed for tumors that are small or less than 3 cm in diameter. This therapy can also be done if surgery cannot be done because of the patient's health condition that does not allow it.
Operation
If the tumor grows larger, the surgeon will perform surgery to remove the tumor to prevent complications. In some cases, surgery cannot completely remove the tumor.
This condition usually occurs if the tumor is located too close to a vital area of the brain or facial nerve, so there is a risk of damaging the surrounding nerves if the tumor is removed. In such conditions, the doctor will perform radiotherapy after surgery to remove the remaining tumor tissue.
In addition to the above measures, the doctor will provide supportive therapy to help overcome the symptoms experienced by the patient. Some of these types of supportive therapy are:
- Giving hearing aids
- Balance therapy (vestibular)
- Occupational therapy
- Physical therapy
Complications of Acoustic Neuroma
Acoustic neuromas are at risk of causing various complications that can be permanent, such as:
- Ears ringing
- Numbness and paralysis of facial muscles
- Balance disorders
- Hearing loss
- Hydrocephalus when the tumor is large enough to compress the brain stem
Acoustic Neuroma Prevention
Not all acoustic neuromas can be prevented, especially if the disease is associated with genetic disorders that are inherited from parents. However, the risk of acoustic neuroma can be reduced by avoiding exposure to loud noises, as well as by consulting before and after radiotherapy.
