A non-cancerous form of tumor, Acoustic Neuroma occurs when nerves connecting your inner ear to the brain are affected. We all have our healthy nerves that are covered by many layers of cells known as Schwann cells that usually functions like a plastic or rubber coating on electric wires. They provide support for nerve impulses but when they start multiplying in number, it may lead to Acoustic Neuroma. Owing to this cause, it is also known as vestibular schwannomas or neurilemmoma. It has the disease to grow slowly over years and does not directly invade the brain. However, it has the tendency to push on as it is in the growing stage. As a result, it can press the cranial nerves that control sensation and facial expression. Tumor with a big size has the potential to press on cerebellum or brain stem and in many cases; it turns out to be deadly.
Majorly there are two forms of Acoustic Neuroma: a form called Neurofibromatosis type – 2 (NF II) and sporadic form.
It has been difficult to find the exact cause of the sporadic form but most of the cases are between the ages of 30 to 60 years. There might be a chance of exposure to some radiation to head and neck during childhood that may increase the risk. As for neurofibromatosis type 2, it is often connected to a family history wherein a person develops it on both his/her auditory nerves.
It often becomes difficult for people to diagnose Acoustic Neuroma because the symptoms are subtle and people relate it to signs of aging. However, some of the symptoms that occur in major cases include:
- Losing your hearing – This is one of the first symptoms that involves gradual loss of hearing but only in one ear. The other ear stays normal.
- Aching in ears – Many cases have reported mild or major aching in their affected ear.
- Tinnitus – This is also referred to as ringing, most patients complain of this constant ringing in their ear.
- Losing sensation – In cases where there is a large tumor present, a certain part of the brainstem gets compressed and this in turn impacts the cranial nerves. As a result, the trigeminal nerve gets affected and one may lose sensation of one side of the mouth and face. A lot of patients have also complained of loss of sense of taste from the back half.
- Headache – Large tumor tends to impact the pressure in the brain and lead to vomiting, headaches and in many cases, altered consciousness.
- Loss of balance, vertigo and dizziness – In cases the tumor affects the inner ear, these symptoms are quite common.
- Problems with vision – This usually takes place in rare cases but happen in cases of extreme severity.
After learning about the symptoms from the patient, the physician often requests some tests for the diagnosis.
Audiometry (Hearing test) – one may hear sounds that are directed to one ear at one time, and this test is conducted by a hearing specialist also known as an audiologist. He plays various range of sounds in different tones and ask the patient to indicate each time he/she is able to hear the sound. Each sound is then repeated at faint levels to ensure at which point patient can barely hear.
Imaging (MRI) – This is the most common test suggested by doctors to detect tumor, that can be as small as 1 -2 millimetre in their diameter. In cases where people can’t bear an MRI, computerized tomography (CT scan) is used, but it has the chances of missing smaller tumors.
Acoustic Neuroma usually follows three main course of treatment.
This is the first step towards treatment mainly because Acoustic Neuroma has a gradual growth process. This means that doctors have to wait for years and watch if the tumor is growing and at what speed. Periodic MRI scans are done by doctors to monitor this growth and suggest other treatment options only if it is necessary.
This includes, removing all parts of the tumor. In most cases, there are three main surgical approaches for removing it.
- Translabyrinthine – It is used mostly in cases of tumor that are larger than 3 centimetres, this includes making an incision behind the ear and bone and some of middle ear. The main pro of this surgery is that it allows the surgeon to see the facial nerve (cranial), before removing the tumor but the con is that it causes permanent hearing loss.
- Retrosigmoid (sub-occiptal)– This includes opening the skull from the back of the head, thereby exposing the tumor. It allows removal of different sized tumor and also includes the possibility of avoiding hearing loss.
- Middle fossa – This one includes removal of a bone above the ear canal to allow access and removal of small tumor in the internal auditory canal. This is a narrow passageway from the middle to inner ear. This also allows preserving the patient’s hearing.
Radiation therapy – This therapy may be suggested in some cases where certain techniques are used to send high doses of radiation, thereby restraining exposure and damage to all the surrounding tissues. It is carried out in two ways -
- Single fraction stereotactic radiosurgery – This includes hundreds of small radiation beams aiming at the tumor in one single session.
- Multi-session fractionated stereotactic radiotherapy – This involves smaller doses of radiation carried out over a period of few weeks.
Even though it is a noncancerous form of tumor, it requires diagnoses at the right time and treatment from the best so that, it may not cause long term problems. This is why it is essential to go for an expert like Max Healthcare. Their team of specialized doctors treat each case fairly and ensures proper treatment is provided in due time. With state-of-art techniques, they make surgeries that are effective and trustworthy. Under the care of experienced doctors, treating tumor in sensitive areas also becomes easier and one can find ways to prevent hearing loss, which is a major concern of people with Acoustic Neuroma.