ACOUSTIC NEUROMAS

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An acoustic neuroma, also known as a vestibular schwannoma, is a non-cancerous tumor that develops on the vestibulocochlear nerve, which connects the inner ear to the brain. This nerve is responsible for hearing and balance, so an acoustic neuroma can affect these functions as it grows.

Acoustic neuromas are relatively rare, accounting for about 8% of all brain tumors. They typically occur in adults between the ages of 30 and 60, and they are more common in women than in men.

The symptoms of an acoustic neuroma often develop slowly and can vary depending on the size and location of the tumor. Common symptoms include:

• Hearing loss, usually in one ear
• Ringing in the ear (tinnitus)
• Problems with balance or unsteadiness
• Dizziness or vertigo
• Facial numbness or tingling
• Weakness of the facial muscles (in rare cases)

Diagnosing an acoustic neuroma involves several steps:

• Medical History and Physical Exam: Your doctor will ask about your symptoms and perform a physical examination, focusing on your hearing and balance.
• Hearing Tests: Audiometry tests measure how well you can hear sounds and understand speech.
• Imaging Tests: MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans provide detailed images of the brain and inner ear to detect the presence of a tumor.

Treatment for acoustic neuromas depends on the size of the tumor, the rate of growth, and the severity of symptoms. Options include:

• Observation: Small, slow-growing tumors that aren't causing significant symptoms may be monitored with regular imaging tests and hearing evaluations.
• Surgery: If the tumor is large or causing significant symptoms, surgical removal may be necessary. The goal is to remove as much of the tumor as possible while preserving hearing and facial nerve function.
• Radiation Therapy: Stereotactic radiosurgery (such as Gamma Knife) delivers a precise dose of radiation to the tumor, often used for smaller tumors or to treat any remaining tumor cells after surgery.
• Medications: Although medications can't shrink the tumor, they can help manage symptoms like dizziness and balance issues.

There are different surgical techniques for removing acoustic neuromas, depending on the size and location of the tumor:

• Translabyrinthine Approach: This method involves accessing the tumor through the inner ear, often used when hearing preservation is not possible.
• Retrosigmoid/Suboccipital Approach: The surgeon accesses the tumor through an incision behind the ear, which may allow for hearing preservation.
• Middle Fossa Approach: This technique is used for small tumors located in the internal auditory canal and aims to preserve hearing.

Early detection and treatment of acoustic neuromas can lead to better outcomes and help maintain quality of life. If you experience any symptoms or have concerns about acoustic neuromas, it's important to consult your healthcare provider for a thorough evaluation.