A vestibular schwannoma, also referred to as acoustic neuroma, acoustic neurinoma, or acoustic neurilemoma, is a benign, slow-growing tumour that develops from the balance and hearing nerves supplying the inner ear.
The tumour develops from an overproduction of Schwann cells--the cells that normally wrap around nerve fibres like onion skin to help support and insulate nerves. The growth of tumour presses against the hearing and balance nerves, usually causing unilateral (one-sided) or asymmetric hearing loss, tinnitus (ringing in the ear), and dizziness/loss of balance. Moreover, it can interfere with the face sensation nerve (the trigeminal nerve), causing facial numbness. If the tumour becomes large, it will eventually press against nearby brain structures (such as the brainstem and the cerebellum), becoming life-threatening.
Also, hearing loss, dizziness, and tinnitus are common symptoms of many middle and inner ear problems (the important point here is that unilateral or asymmetric symptoms are the worrisome ones).
There are three treatment options for managing a vestibular schwannoma – surgical removal, radiation therapy and monitoring.
Surgery – The tumour is surgically removed (excised), although the exact type of operation done depends on the size of the tumour and the level of hearing in the affected ear. As the tumour grows larger, surgical removal is more complicated because the tumour may have damaged the nerves that control facial movement, hearing, and balance and may also have affected other nerves and structures of the brain.
Radiation Therapy - Radiosurgery may be used to reduce the size or limit the growth of the tumour. Radiation therapy is sometimes the preferred option for elderly patients, patients in poor medical health, patients with bilateral vestibular schwannoma (tumour affecting both ears), or patients whose tumour is affecting their only hearing ear.
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