Mount Sinai has made important contributions to the management of these benign tumors, which produce hearing loss, tinnitus, and dizziness. While surgery for acoustic neuromas may carry the risk of facial weakness and hearing loss, the majority of our patients experience no facial weakness or minimal temporary facial weakness. Similarly, hearing is preserved for a large percentage of patients, depending upon the preoperative hearing level and tumor size. Early diagnosis and treatment are critical to achieving excellent operative results, which Mount Sinai reports to be on par with few top institutions in the world.
Acoustic neuroma (vestibular schwannoma) is a benign tumor of the hearing and balance nerve that usually causes progressive hearing loss in one ear. Although it is an uncommon condition, in experienced hands a good outcome can be expected in most cases.
Acoustic neuromas are among the most common brain tumors. Nevertheless, their incidence is low, about 1 in 100,000, according to the National Cancer Institute. This works out to about 3,000 new cases of acoustic neuromas in the United States each year.
In most cases of acoustic neuroma, the chief complaint is hearing loss in one ear. Hearing loss tends to progress gradually, although sudden hearing loss is a possibility. Patients may also have trouble understanding phone conversations. Tinnitus (ringing in the ear) is also common, and tinnitus in one ear can be the first sign that something is wrong.
Not every patient with an acoustic neuroma has hearing loss, though. Some people maintain normal hearing even with large tumors. The degree of hearing loss does not depend on the size of the tumor.
Other symptoms of an acoustic neuroma include: balance problems, facial numbness or tingling, and other neurological problems, such as facial twitching, eyelid spasms and headaches.
Acoustic neuromas are usually discovered after abnormal hearing test (audiogram). An MRI will show the tumor. Other tests, including special hearing tests (ABR) and CT scans, may be recommended to develop a treatment plan.
The treatment of acoustic neuroma is individualized for each patient. The choice of treatment depends on several factors:
Patients with newly discovered acoustic neuromas receive a full consultation with examination of the hearing, balance, and nerves. Special diagnostic tests of the hearing and balance systems are ordered when needed. Because we are a multi-disciplinary center specializing in the treatment of skull base tumors, consultations from our colleagues in neurosurgery and radiation therapy are usually obtained.
The treatment options for acoustic neuroma include: