An acoustic neuroma, also called a vestibular schwannoma, is a Schwann cell—derived tumor of the 8th cranial nerve. Symptoms include unilateral sensorineural hearing loss, tinnitus, and vertigo. Diagnosis is based on audiology and confirmed by MRI. Most tumors originate in the internal auditory canal and may enlarge into the cerebellopontine angle. Very large tumors may compress adjacent cranial nerve roots, the cerebellum, or the brain stem. Treatment with observation (repeat MRI) is appropriate for small (< 1.5—2 cm) tumors. When required, treatment is surgical excision. There is a significant risk of hearing loss following surgery; facial nerve injury is less common but also a risk. Stereotactic radiation therapy may be useful for older patients or those who are not good candidates for surgery. Recurrence is extremely rare.
See Acoustic Neuroma in The Manuals.
References
Halliday J, Rutherford SA, McCabe MG, Evans DG. An update on the diagnosis and treatment of vestibular schwannoma. Expert Rev Neurother. 2018 Jan;18(1):29-39
Lin EP, Crane BT. The Management and Imaging of Vestibular Schwannomas. AJNR Am J Neuroradiol. 2017 Nov;38(11):2034-2043full-text
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